Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $1,949.84 / $9,332.54	Facility		$199.53	$1,949.84	$9,332.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $208.93 / $588.84	Professional		$89.13	$208.93	$588.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $275.42 / $457.09	Professional		$269.15	$275.42	$457.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $457.09	Facility		$302.00	$302.00	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $263.03 / $630.96	Professional		$134.90	$263.03	$630.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $275.42 / $660.69	Facility		$154.88	$275.42	$660.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $275.42 / $630.96	Professional		$154.88	$275.42	$630.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $69.18	Professional		$32.36	$33.11	$69.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $371.54 / $501.19	Facility		$234.42	$371.54	$501.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $346.74 / $346.74	Facility		$245.47	$346.74	$346.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $316.23 / $630.96	Professional		$144.54	$316.23	$630.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,995.26 / $3,801.89	Facility		$1,348.96	$1,995.26	$3,801.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $302.00 / $524.81	Professional		$141.25	$302.00	$524.81
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $2,454.71 / $4,786.30	Facility		$676.08	$2,454.71	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $245.47 / $562.34	Professional		$125.89	$245.47	$562.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $204.17 / $398.11	Professional		$107.15	$204.17	$398.11