Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $2,187.76 / $14,454.40	Facility		$489.78	$2,187.76	$14,454.40
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,754.23 / $2,754.23 / $2,754.23	Facility	50	$2,754.23	$2,754.23	$2,754.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $489.78 / $1,380.38	Professional		$245.47	$489.78	$1,380.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $645.65 / $2,691.53 / $3,801.89	Professional	50	$645.65	$2,691.53	$3,801.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $436.52 / $524.81	Professional		$288.40	$436.52	$524.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $346.74 / $478.63	Facility		$346.74	$346.74	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $588.84 / $851.14	Professional		$281.84	$588.84	$851.14
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $616.60 / $1,258.93	Facility		$190.55	$616.60	$1,258.93
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 $190.55 / $602.56 / $1,148.15	Professional		$190.55	$602.56	$1,148.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $158.49	Professional		$32.36	$33.11	$158.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $489.78 / $1,000.00	Facility		$398.11	$489.78	$1,000.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $316.23 / $331.13	Facility		$239.88	$316.23	$331.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $501.19 / $707.95	Professional		$302.00	$501.19	$707.95
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 $323.59 / $467.74 / $1,230.27	Professional		$323.59	$467.74	$1,230.27
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 $407.38 / $660.69 / $1,047.13	Professional		$407.38	$660.69	$1,047.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $288.40 / $478.63	Professional		$32.36	$288.40	$478.63