Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $1,096.48 / $17,782.79	Facility		$109.65	$1,096.48	$17,782.79
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,630.27 / $2,630.27 / $2,630.27	Facility	50	$2,630.27	$2,630.27	$2,630.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $123.03 / $338.84	Professional		$58.88	$123.03	$338.84
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $371.54 / $389.05 / $416.87	Professional	50	$371.54	$389.05	$416.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $562.34 / $1,047.13	Facility		$467.74	$562.34	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $141.25 / $281.84	Professional		$72.44	$141.25	$281.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $151.36 / $660.69	Facility		$83.18	$151.36	$660.69
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $977.24 / $2,570.40 / $5,011.87	Facility	50	$977.24	$2,570.40	$5,011.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $147.91 / $398.11	Professional		$83.18	$147.91	$398.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $52.48	Professional		$32.36	$33.11	$52.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $194.98 / $213.80	Facility		$151.36	$194.98	$213.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $134.90 / $239.88	Facility		$131.83	$134.90	$239.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $144.54 / $245.47	Professional		$83.18	$144.54	$245.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,949.84 / $3,715.35	Facility		$1,318.26	$1,949.84	$3,715.35
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $2,238.72 / $3,019.95 / $5,623.41	Facility	50	$2,238.72	$3,019.95	$5,623.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $134.90 / $234.42	Professional		$79.43	$134.90	$234.42
United Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $2,454.71 / $4,786.30	Facility		$891.25	$2,454.71	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $131.83 / $245.47	Professional		$74.13	$131.83	$245.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $100.00 / $154.88	Professional		$52.48	$100.00	$154.88