Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $1,548.82 / $17,782.79	Facility		$269.15	$1,548.82	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $223.87 / $676.08	Professional		$128.82	$223.87	$676.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Professional	50	$1,584.89	$1,584.89	$1,584.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $275.42 / $446.68	Professional		$173.78	$275.42	$446.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $363.08	Facility		$218.78	$218.78	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $363.08 / $616.60	Professional		$213.80	$363.08	$616.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $346.74 / $630.96	Facility		$190.55	$346.74	$630.96
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,230.27 / $2,137.96 / $4,365.16	Facility	50	$1,230.27	$2,137.96	$4,365.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $346.74 / $549.54	Professional		$194.98	$346.74	$549.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $416.87 / $436.52	Facility		$302.00	$416.87	$436.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Facility		$295.12	$295.12	$295.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $338.84 / $562.34	Professional		$194.98	$338.84	$562.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,548.82 / $2,951.21	Facility		$1,148.15	$1,548.82	$2,951.21
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $1,737.80 / $2,344.23 / $4,466.84	Facility	50	$1,737.80	$2,344.23	$4,466.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $316.23 / $512.86	Professional		$194.98	$316.23	$512.86
United Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,995.26 / $4,265.80	Facility		$645.65	$1,995.26	$4,265.80
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $288.40 / $537.03	Professional		$173.78	$288.40	$537.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $223.87 / $316.23	Professional		$128.82	$223.87	$316.23