Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $1,318.26 / $18,620.87	Facility		$234.42	$1,318.26	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $204.17 / $676.08	Professional		$112.20	$204.17	$676.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $245.47 / $363.08 / $1,513.56	Professional	50	$245.47	$363.08	$1,513.56
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $512.86 / $512.86 / $512.86	Professional	50	$512.86	$512.86	$512.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Facility		$177.83	$177.83	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $323.59 / $537.03	Professional		$190.55	$323.59	$537.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $295.12 / $549.54	Facility		$169.82	$295.12	$549.54
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $562.34 / $891.25 / $1,621.81	Facility	50	$562.34	$891.25	$1,621.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $295.12 / $489.78	Professional		$169.82	$295.12	$489.78
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 $251.19 / $363.08 / $389.05	Facility		$251.19	$363.08	$389.05
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $263.03	Facility		$257.04	$257.04	$263.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $302.00 / $489.78	Professional		$173.78	$302.00	$489.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $691.83 / $1,318.26	Facility		$524.81	$691.83	$1,318.26
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $794.33 / $1,047.13 / $1,995.26	Facility	50	$794.33	$1,047.13	$1,995.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $281.84 / $446.68	Professional		$169.82	$281.84	$446.68
United Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $891.25 / $2,041.74	Facility		$645.65	$891.25	$2,041.74
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $251.19 / $478.63	Professional		$151.36	$251.19	$478.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $199.53 / $281.84	Professional		$112.20	$199.53	$281.84