Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $1,000.00 / $17,782.79	Facility		$169.82	$1,000.00	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $138.04 / $338.84	Professional		$77.62	$138.04	$338.84
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $524.81 / $524.81 / $524.81	Professional	50	$524.81	$524.81	$524.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $199.53	Professional		$123.03	$123.03	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $870.96 / $1,047.13	Facility		$707.95	$870.96	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $186.21 / $380.19	Professional		$97.72	$186.21	$380.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $190.55 / $660.69	Facility		$100.00	$190.55	$660.69
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,737.80 / $2,570.40 / $5,011.87	Facility	50	$1,737.80	$2,570.40	$5,011.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $186.21 / $436.52	Professional		$100.00	$186.21	$436.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $263.03 / $281.84	Facility		$186.21	$263.03	$281.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $239.88	Facility		$181.97	$181.97	$239.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $190.55 / $338.84	Professional		$109.65	$190.55	$338.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,949.84 / $3,715.35	Facility		$1,445.44	$1,949.84	$3,715.35
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $2,137.96 / $2,951.21 / $5,623.41	Facility	50	$2,137.96	$2,951.21	$5,623.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $186.21 / $316.23	Professional		$107.15	$186.21	$316.23
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 $97.72 / $173.78 / $309.03	Professional		$97.72	$173.78	$309.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $134.90 / $218.78	Professional		$72.44	$134.90	$218.78