Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $1,000.00 / $13,803.84	Facility		$537.03	$1,000.00	$13,803.84
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,187.76 / $2,187.76 / $2,187.76	Facility	50	$2,187.76	$2,187.76	$2,187.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $398.11 / $1,096.48	Professional		$288.40	$398.11	$1,096.48
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $380.19 / $724.44 / $2,187.76	Professional	50	$380.19	$724.44	$2,187.76
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $239.88 / $346.74 / $549.54	Professional	54	$239.88	$346.74	$549.54
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $13.49 / $66.07 / $72.44	Professional	55	$13.49	$66.07	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $380.19 / $630.96	Professional		$251.19	$380.19	$630.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $691.83	Facility		$645.65	$645.65	$691.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $524.81 / $1,000.00	Professional		$309.03	$524.81	$1,000.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $467.74 / $870.96	Facility		$346.74	$467.74	$870.96
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,445.44 / $2,344.23 / $4,168.69	Facility	50	$1,445.44	$2,344.23	$4,168.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $478.63 / $851.14	Professional		$346.74	$478.63	$851.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $213.80	Professional		$32.36	$33.11	$213.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $630.96 / $676.08	Facility		$457.09	$630.96	$676.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $446.68 / $457.09	Facility		$275.42	$446.68	$457.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $707.95 / $891.25	Professional		$426.58	$707.95	$891.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,659.59 / $3,162.28	Facility		$1,202.26	$1,659.59	$3,162.28
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $1,778.28 / $2,454.71 / $4,677.35	Facility	50	$1,778.28	$2,454.71	$4,677.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $645.65 / $954.99	Professional		$446.68	$645.65	$954.99
United Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $1,905.46 / $4,365.16	Facility		$398.11	$1,905.46	$4,365.16
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $478.63 / $891.25	Professional		$338.84	$478.63	$891.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $398.11 / $660.69	Professional		$44.67	$398.11	$660.69