Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $2,818.38 / $17,782.79	Facility		$549.54	$2,818.38	$17,782.79
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,511.89 / $3,019.95 / $14,454.40	Facility	50	$2,511.89	$3,019.95	$14,454.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $407.38 / $1,148.15	Professional		$275.42	$407.38	$1,148.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $436.52 / $1,122.02 / $2,290.87	Professional	50	$436.52	$1,122.02	$2,290.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Professional		$724.44	$724.44	$724.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Facility		$489.78	$489.78	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $676.08 / $1,071.52	Professional		$436.52	$676.08	$1,071.52
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $676.08 / $1,380.38	Facility		$371.54	$676.08	$1,380.38
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $3,801.89 / $6,456.54 / $10,964.78	Facility	50	$3,801.89	$6,456.54	$10,964.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $645.65 / $954.99	Professional		$371.54	$645.65	$954.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $128.82	Professional		$32.36	$33.11	$128.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $724.44 / $776.25	Facility		$524.81	$724.44	$776.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $512.86 / $524.81	Facility		$512.86	$512.86	$524.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $707.95 / $1,000.00	Professional		$407.38	$707.95	$1,000.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $4,365.16 / $8,317.64	Facility		$3,311.31	$4,365.16	$8,317.64
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $4,897.79 / $6,606.93 / $12,302.69	Facility	50	$4,897.79	$6,606.93	$12,302.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $602.56 / $891.25	Professional		$426.58	$602.56	$891.25
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $5,754.40 / $10,715.19	Facility		$1,995.26	$5,754.40	$10,715.19
United Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $537.03 / $1,023.29	Professional		$363.08	$537.03	$1,023.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $389.05 / $549.54	Professional		$251.19	$389.05	$549.54