Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $2,754.23 / $6,606.93	Facility		$208.93	$2,754.23	$6,606.93
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,584.89 / $4,570.88 / $5,754.40	Facility	50	$1,584.89	$4,570.88	$5,754.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $204.17 / $776.25	Professional		$102.33	$204.17	$776.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $154.88 / $398.11 / $1,380.38	Professional	50	$154.88	$398.11	$1,380.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $208.93 / $380.19	Professional		$177.83	$208.93	$380.19
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $162.18 / $295.12 / $426.58	Professional	50	$162.18	$295.12	$426.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $870.96 / $1,348.96	Facility		$501.19	$870.96	$1,348.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $245.47 / $524.81	Professional		$125.89	$245.47	$524.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $257.04 / $831.76	Facility		$131.83	$257.04	$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 $131.83 / $251.19 / $562.34	Professional		$131.83	$251.19	$562.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $91.20	Professional		$32.36	$33.11	$91.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $363.08 / $389.05	Facility		$257.04	$363.08	$389.05
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $263.03 / $309.03	Facility		$257.04	$263.03	$309.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $263.03 / $478.63	Professional		$151.36	$263.03	$478.63
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 $144.54 / $263.03 / $457.09	Professional		$144.54	$263.03	$457.09
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 $128.82 / $239.88 / $467.74	Professional		$128.82	$239.88	$467.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $181.97 / $302.00	Professional		$95.50	$181.97	$302.00