Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $2,290.87 / $17,782.79	Facility		$223.87	$2,290.87	$17,782.79
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,511.89 / $2,511.89 / $2,570.40	Facility	50	$2,511.89	$2,511.89	$2,570.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $251.19 / $831.76	Professional		$112.20	$251.19	$831.76
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $338.84 / $1,202.26 / $3,090.30	Professional	50	$338.84	$1,202.26	$3,090.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $257.04	Professional		$229.09	$229.09	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $478.63 / $562.34	Facility		$407.38	$478.63	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $257.04 / $676.08	Professional		$123.03	$257.04	$676.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $218.78 / $602.56	Facility		$120.23	$218.78	$602.56
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 $120.23 / $213.80 / $524.81	Professional		$120.23	$213.80	$524.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $104.71	Professional		$32.36	$33.11	$104.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $407.38 / $501.19	Facility		$213.80	$407.38	$501.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Facility		$338.84	$338.84	$338.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $338.84 / $616.60	Professional		$165.96	$338.84	$616.60
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 $162.18 / $316.23 / $562.34	Professional		$162.18	$316.23	$562.34
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 $141.25 / $275.42 / $562.34	Professional		$141.25	$275.42	$562.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $213.80 / $389.05	Professional		$112.20	$213.80	$389.05