Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $1,548.82 / $18,620.87	Facility		$275.42	$1,548.82	$18,620.87
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,290.87 / $2,290.87 / $2,290.87	Facility	50	$2,290.87	$2,290.87	$2,290.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $229.09 / $741.31	Professional		$128.82	$229.09	$741.31
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $295.12 / $537.03 / $1,412.54	Professional	50	$295.12	$537.03	$1,412.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $363.08 / $446.68	Professional		$251.19	$363.08	$446.68
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $380.19 / $380.19 / $602.56	Professional	50	$380.19	$380.19	$602.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $323.59	Facility		$194.98	$194.98	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $338.84 / $575.44	Professional		$199.53	$338.84	$575.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $331.13 / $575.44	Facility		$186.21	$331.13	$575.44
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,230.27 / $2,041.74 / $3,630.78	Facility	50	$1,230.27	$2,041.74	$3,630.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $323.59 / $512.86	Professional		$186.21	$323.59	$512.86
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 $275.42 / $380.19 / $407.38	Facility		$275.42	$380.19	$407.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $281.84	Facility		$275.42	$275.42	$281.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $331.13 / $512.86	Professional		$190.55	$331.13	$512.86
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 $181.97 / $302.00 / $478.63	Professional		$181.97	$302.00	$478.63
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 $165.96 / $269.15 / $501.19	Professional		$165.96	$269.15	$501.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $208.93 / $295.12	Professional		$123.03	$208.93	$295.12