Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $2,570.40 / $17,782.79	Facility		$190.55	$2,570.40	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $194.98 / $575.44	Professional		$79.43	$194.98	$575.44
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $190.55 / $512.86 / $1,096.48	Professional	50	$190.55	$512.86	$1,096.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $562.34 / $1,348.96	Facility		$467.74	$562.34	$1,348.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $223.87 / $616.60	Professional		$91.20	$223.87	$616.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $223.87 / $831.76	Facility		$97.72	$223.87	$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 $97.72 / $218.78 / $645.65	Professional		$97.72	$218.78	$645.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $371.54 / $467.74	Facility		$257.04	$371.54	$467.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $281.84 / $575.44	Professional		$120.23	$281.84	$575.44
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 $114.82 / $251.19 / $537.03	Professional		$114.82	$251.19	$537.03
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 $100.00 / $234.42 / $501.19	Professional		$100.00	$234.42	$501.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $147.91 / $354.81	Professional		$77.62	$147.91	$354.81