Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $524.81 / $9,772.37	Facility		$109.65	$524.81	$9,772.37
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $977.24 / $1,258.93 / $1,819.70	Facility	50	$977.24	$1,258.93	$1,819.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $109.65 / $457.09	Professional		$57.54	$109.65	$457.09
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $85.11 / $162.18 / $524.81	Professional	50	$85.11	$162.18	$524.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $102.33 / $154.88	Professional		$87.10	$102.33	$154.88
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $87.10 / $144.54 / $173.78	Professional	50	$87.10	$144.54	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $707.95 / $870.96	Facility		$501.19	$707.95	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $125.89 / $275.42	Professional		$72.44	$125.89	$275.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $123.03 / $223.87	Facility		$69.18	$123.03	$223.87
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $676.08 / $676.08 / $676.08	Facility	50	$676.08	$676.08	$676.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $125.89 / $223.87	Professional		$72.44	$125.89	$223.87
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 $128.82 / $181.97 / $194.98	Facility		$128.82	$181.97	$194.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $134.90	Facility		$128.82	$128.82	$134.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $147.91 / $239.88	Professional		$83.18	$147.91	$239.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $426.58 / $537.03	Facility		$426.58	$426.58	$537.03
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $630.96 / $630.96 / $794.33	Facility	50	$630.96	$630.96	$794.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $131.83 / $223.87	Professional		$81.28	$131.83	$223.87
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 $74.13 / $123.03 / $223.87	Professional		$74.13	$123.03	$223.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $97.72 / $147.91	Professional		$51.29	$97.72	$147.91