Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $524.81 / $17,782.79	Facility		$120.23	$524.81	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $131.83 / $346.74	Professional		$61.66	$131.83	$346.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $134.90 / $134.90 / $134.90	Professional	50	$134.90	$134.90	$134.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $117.49 / $158.49	Professional		$112.20	$117.49	$158.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $562.34 / $1,348.96	Facility		$467.74	$562.34	$1,348.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $158.49 / $416.87	Professional		$75.86	$158.49	$416.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $162.18 / $831.76	Facility		$85.11	$162.18	$831.76
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $977.24 / $3,235.94 / $6,760.83	Facility	50	$977.24	$3,235.94	$6,760.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $158.49 / $537.03	Professional		$85.11	$158.49	$537.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $263.03 / $323.59	Facility		$177.83	$263.03	$323.59
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $218.78 / $309.03	Facility		$190.55	$218.78	$309.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $194.98 / $398.11	Professional		$91.20	$194.98	$398.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,570.40 / $4,897.79	Facility		$1,778.28	$2,570.40	$4,897.79
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $2,630.27 / $3,890.45 / $7,413.10	Facility	50	$2,630.27	$3,890.45	$7,413.10
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $169.82 / $338.84	Professional		$83.18	$169.82	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $3,090.30 / $5,011.87	Facility		$891.25	$3,090.30	$5,011.87
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $162.18 / $346.74	Professional		$79.43	$162.18	$346.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $117.49 / $269.15	Professional		$61.66	$117.49	$269.15