Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $1,122.02 / $17,782.79	Facility		$223.87	$1,122.02	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $151.36 / $416.87	Professional		$104.71	$151.36	$416.87
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $154.88 / $234.42 / $933.25	Professional	50	$154.88	$234.42	$933.25
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $331.13 / $331.13 / $331.13	Professional	50	$331.13	$331.13	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $208.93 / $407.38	Professional		$128.82	$208.93	$407.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $181.97 / $346.74	Facility		$107.15	$181.97	$346.74
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $724.44 / $1,174.90 / $2,089.30	Facility	50	$724.44	$1,174.90	$2,089.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $181.97 / $331.13	Professional		$107.15	$181.97	$331.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $87.10	Professional		$32.36	$33.11	$87.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $245.47 / $269.15	Facility		$177.83	$245.47	$269.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $177.83 / $181.97	Facility		$91.20	$177.83	$181.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $275.42 / $346.74	Professional		$165.96	$275.42	$346.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $831.76 / $1,584.89	Facility		$549.54	$831.76	$1,584.89
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $812.83 / $1,230.27 / $2,344.23	Facility	50	$812.83	$1,230.27	$2,344.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $257.04 / $354.81	Professional		$181.97	$257.04	$354.81
United Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $1,096.48 / $2,511.89	Facility		$154.88	$1,096.48	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $181.97 / $346.74	Professional		$131.83	$181.97	$346.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $158.49 / $263.03	Professional		$17.78	$158.49	$263.03