Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $5,754.40 / $9,772.37	Facility		$436.52	$5,754.40	$9,772.37
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,187.76 / $7,762.47 / $9,772.37	Facility	50	$2,187.76	$7,762.47	$9,772.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $446.68 / $1,412.54	Professional		$204.17	$446.68	$1,412.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $281.84 / $724.44 / $2,754.23	Professional	50	$281.84	$724.44	$2,754.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $323.59 / $724.44	Professional		$181.97	$323.59	$724.44
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $436.52 / $575.44 / $1,318.26	Professional	50	$436.52	$575.44	$1,318.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,071.52 / $2,630.27	Facility		$707.95	$1,071.52	$2,630.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $489.78 / $1,202.26	Professional		$239.88	$489.78	$1,202.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $524.81 / $1,698.24	Facility		$269.15	$524.81	$1,698.24
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $3,311.31 / $7,943.28 / $14,125.38	Facility	50	$3,311.31	$7,943.28	$14,125.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $501.19 / $1,230.27	Professional		$269.15	$501.19	$1,230.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $165.96	Professional		$32.36	$33.11	$165.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $794.33 / $891.25	Facility		$562.34	$794.33	$891.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $602.56 / $602.56	Facility		$602.56	$602.56	$602.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $575.44 / $1,096.48	Professional		$275.42	$575.44	$1,096.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $5,495.41 / $10,471.29	Facility		$3,715.35	$5,495.41	$10,471.29
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $5,623.41 / $8,128.31 / $15,848.93	Facility	50	$5,623.41	$8,128.31	$15,848.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $549.54 / $1,000.00	Professional		$257.04	$549.54	$1,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $6,760.83 / $11,220.18	Facility		$1,995.26	$6,760.83	$11,220.18
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $501.19 / $1,000.00	Professional		$263.03	$501.19	$1,000.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $331.13 / $676.08	Professional		$173.78	$331.13	$676.08