Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $2,041.74 / $17,782.79	Facility		$45.71	$2,041.74	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $85.11 / $380.19	Professional		$28.18	$85.11	$380.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $208.93 / $208.93 / $208.93	Professional	50	$208.93	$208.93	$208.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Professional		$47.86	$47.86	$47.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $501.19 / $562.34	Facility		$467.74	$501.19	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $74.13 / $204.17	Professional		$34.67	$74.13	$204.17
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $177.83 / $831.76	Facility		$64.57	$177.83	$831.76
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,905.46 / $3,235.94 / $6,760.83	Facility	50	$1,905.46	$3,235.94	$6,760.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $151.36 / $537.03	Professional		$60.26	$151.36	$537.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $32.36 / $33.11	Professional		$17.38	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $67.61 / $288.40	Facility		$54.95	$67.61	$288.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $45.71 / $309.03	Facility		$44.67	$45.71	$309.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $58.88 / $83.18	Professional		$35.48	$58.88	$83.18
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 $33.88 / $52.48 / $79.43	Professional		$33.88	$52.48	$79.43
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 $31.62 / $57.54 / $199.53	Professional		$31.62	$57.54	$199.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $40.74 / $67.61	Professional		$35.48	$40.74	$67.61