Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $3,090.30 / $14,454.40	Facility		$120.23	$3,090.30	$14,454.40
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,235.94 / $3,235.94 / $3,235.94	Facility	50	$3,235.94	$3,235.94	$3,235.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $125.89 / $316.23	Professional		$64.57	$125.89	$316.23
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $18.20 / $467.74 / $851.14	Professional	50	$18.20	$467.74	$851.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $208.93	Professional		$93.33	$93.33	$208.93
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 $79.43 / $147.91 / $275.42	Professional		$79.43	$147.91	$275.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $177.83 / $831.76	Facility		$97.72	$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 $97.72 / $169.82 / $489.78	Professional		$97.72	$169.82	$489.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $190.55 / $263.03	Facility		$162.18	$190.55	$263.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $134.90 / $309.03	Facility		$131.83	$134.90	$309.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $138.04 / $245.47	Professional		$77.62	$138.04	$245.47
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 $74.13 / $134.90 / $229.09	Professional		$74.13	$134.90	$229.09
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 $69.18 / $128.82 / $229.09	Professional		$69.18	$128.82	$229.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $93.33 / $138.04	Professional		$48.98	$93.33	$138.04