Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $239.88 / $18,620.87	Facility		$97.72	$239.88	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $107.15 / $288.40	Professional		$61.66	$107.15	$288.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $123.03	Professional		$102.33	$102.33	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $141.25 / $302.00	Professional		$72.44	$141.25	$302.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $154.88 / $309.03	Facility		$104.71	$154.88	$309.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $147.91 / $295.12	Professional		$97.72	$147.91	$295.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $194.98 / $234.42	Facility		$131.83	$194.98	$234.42
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $158.49	Facility		$154.88	$154.88	$158.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $151.36 / $288.40	Professional		$70.79	$151.36	$288.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $562.34 / $1,096.48	Facility		$371.54	$562.34	$1,096.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $134.90 / $234.42	Professional		$70.79	$134.90	$234.42
United Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $741.31 / $1,862.09	Facility		$501.19	$741.31	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $131.83 / $275.42	Professional		$69.18	$131.83	$275.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $81.28 / $165.96	Professional		$42.66	$81.28	$165.96