Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $1,819.70 / $6,456.54	Facility		$77.62	$1,819.70	$6,456.54
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,819.70 / $1,819.70 / $3,388.44	Facility	50	$1,819.70	$1,819.70	$3,388.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $102.33 / $389.05	Professional		$42.66	$102.33	$389.05
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $60.26 / $251.19 / $660.69	Professional	50	$60.26	$251.19	$660.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $77.62 / $114.82	Professional		$38.90	$77.62	$114.82
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $56.23 / $138.04 / $281.84	Professional	50	$56.23	$138.04	$281.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $467.74 / $562.34	Facility		$107.15	$467.74	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $104.71 / $213.80	Professional		$54.95	$104.71	$213.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $100.00 / $194.98	Facility		$57.54	$100.00	$194.98
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 $57.54 / $100.00 / $173.78	Professional		$57.54	$100.00	$173.78
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 $109.65 / $144.54 / $154.88	Facility		$109.65	$144.54	$154.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Facility		$102.33	$102.33	$102.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $104.71 / $186.21	Professional		$60.26	$104.71	$186.21
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 $57.54 / $104.71 / $173.78	Professional		$57.54	$104.71	$173.78
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 $53.70 / $100.00 / $190.55	Professional		$53.70	$100.00	$190.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $74.13 / $117.49	Professional		$38.90	$74.13	$117.49