Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $776.25 / $10,232.93	Facility		$204.17	$776.25	$10,232.93
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $645.65 / $851.14 / $6,606.93	Facility	50	$645.65	$851.14	$6,606.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $154.88 / $457.09	Professional		$100.00	$154.88	$457.09
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $165.96 / $537.03 / $954.99	Professional	50	$165.96	$537.03	$954.99
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $186.21 / $245.47 / $398.11	Professional	50	$186.21	$245.47	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $707.95 / $870.96	Facility		$162.18	$707.95	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $199.53 / $398.11	Professional		$114.82	$199.53	$398.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $162.18 / $331.13	Facility		$107.15	$162.18	$331.13
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $741.31 / $1,174.90 / $2,137.96	Facility	50	$741.31	$1,174.90	$2,137.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $165.96 / $302.00	Professional		$107.15	$165.96	$302.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $251.19 / $281.84	Facility		$181.97	$251.19	$281.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $186.21 / $190.55	Facility		$154.88	$186.21	$190.55
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $257.04 / $346.74	Professional		$158.49	$257.04	$346.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $831.76 / $1,621.81	Facility		$588.84	$831.76	$1,621.81
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $891.25 / $1,258.93 / $2,398.83	Facility	50	$891.25	$1,258.93	$2,398.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $229.09 / $323.59	Professional		$147.91	$229.09	$323.59
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $1,071.52 / $2,454.71	Facility		$416.87	$1,071.52	$2,454.71
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $181.97 / $331.13	Professional		$125.89	$181.97	$331.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $144.54 / $204.17	Professional		$97.72	$144.54	$204.17