Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $316.23 / $14,454.40	Facility		$67.61	$316.23	$14,454.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $117.49 / $354.81	Professional		$57.54	$117.49	$354.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $60.26 / $354.81 / $1,071.52	Professional	50	$60.26	$354.81	$1,071.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $112.20 / $138.04	Professional		$97.72	$112.20	$138.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $467.74 / $562.34	Facility		$154.88	$467.74	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $144.54 / $295.12	Professional		$72.44	$144.54	$295.12
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $147.91 / $295.12	Facility		$77.62	$147.91	$295.12
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 $77.62 / $147.91 / $275.42	Professional		$77.62	$147.91	$275.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $61.66	Professional		$32.36	$33.11	$61.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $213.80 / $234.42	Facility		$120.23	$213.80	$234.42
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $120.23 / $158.49	Facility		$109.65	$120.23	$158.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $158.49 / $288.40	Professional		$87.10	$158.49	$288.40
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 $1,995.26 / $2,951.21 / $5,623.41	Facility	50	$1,995.26	$2,951.21	$5,623.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $128.82 / $245.47	Professional		$70.79	$128.82	$245.47
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 $70.79 / $125.89 / $234.42	Professional		$70.79	$125.89	$234.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $114.82 / $194.98	Professional		$61.66	$114.82	$194.98