Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $831.76 / $10,232.93	Facility		$95.50	$831.76	$10,232.93
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $977.24 / $1,445.44 / $3,162.28	Facility	50	$977.24	$1,445.44	$3,162.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $120.23 / $524.81	Professional		$50.12	$120.23	$524.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $72.44 / $144.54 / $457.09	Professional	50	$72.44	$144.54	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $112.20 / $169.82	Professional		$70.79	$112.20	$169.82
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $72.44 / $151.36 / $204.17	Professional	50	$72.44	$151.36	$204.17
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 $61.66 / $123.03 / $302.00	Professional		$61.66	$123.03	$302.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $114.82 / $245.47	Facility		$63.10	$114.82	$245.47
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $977.24 / $977.24 / $977.24	Facility	50	$977.24	$977.24	$977.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $114.82 / $245.47	Professional		$63.10	$114.82	$245.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $58.88	Professional		$32.36	$33.11	$58.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $199.53 / $223.87	Facility		$131.83	$199.53	$223.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $147.91 / $275.42	Professional		$72.44	$147.91	$275.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $851.14	Facility		$676.08	$676.08	$851.14
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $1,000.00 / $1,000.00 / $1,288.25	Facility	50	$1,000.00	$1,000.00	$1,288.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $138.04 / $251.19	Professional		$69.18	$138.04	$251.19
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $549.54 / $5,754.40	Facility		$158.49	$549.54	$5,754.40
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $123.03 / $257.04	Professional		$64.57	$123.03	$257.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $83.18 / $169.82	Professional		$43.65	$83.18	$169.82