Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $1,000.00 / $9,772.37	Facility		$93.33	$1,000.00	$9,772.37
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $537.03 / $1,318.26 / $3,162.28	Facility	50	$537.03	$1,318.26	$3,162.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $112.20 / $512.86	Professional		$50.12	$112.20	$512.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $74.13 / $151.36 / $537.03	Professional	50	$74.13	$151.36	$537.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $52.48 / $91.20	Professional		$38.90	$52.48	$91.20
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $112.20 / $147.91 / $208.93	Professional	50	$112.20	$147.91	$208.93
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 $61.66 / $114.82 / $251.19	Professional		$61.66	$114.82	$251.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $109.65 / $204.17	Facility		$61.66	$109.65	$204.17
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 $61.66 / $109.65 / $204.17	Professional		$61.66	$109.65	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $53.70	Professional		$32.36	$33.11	$53.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $169.82 / $181.97	Facility		$117.49	$169.82	$181.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $125.89	Facility		$123.03	$123.03	$125.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $125.89 / $223.87	Professional		$72.44	$125.89	$223.87
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 $69.18 / $125.89 / $208.93	Professional		$69.18	$125.89	$208.93
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 $63.10 / $112.20 / $208.93	Professional		$63.10	$112.20	$208.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $83.18 / $138.04	Professional		$43.65	$83.18	$138.04