Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $2,818.38 / $10,232.93	Facility		$229.09	$2,818.38	$10,232.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $177.83 / $426.58	Professional		$107.15	$177.83	$426.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $251.19 / $331.13	Professional		$218.78	$251.19	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $251.19 / $645.65	Facility		$165.96	$251.19	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $239.88 / $436.52	Professional		$151.36	$239.88	$436.52
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $269.15 / $467.74	Facility		$162.18	$269.15	$467.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $269.15 / $416.87	Professional		$169.82	$269.15	$416.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $77.62	Professional		$32.36	$33.11	$77.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $275.42 / $346.74	Facility		$162.18	$275.42	$346.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $229.09 / $234.42	Facility		$131.83	$229.09	$234.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $288.40 / $426.58	Professional		$162.18	$288.40	$426.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $4,570.88 / $8,709.64	Facility		$3,090.30	$4,570.88	$8,709.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $234.42 / $363.08	Professional		$158.49	$234.42	$363.08
United Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $5,754.40 / $9,332.54	Facility		$1,047.13	$5,754.40	$9,332.54
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $218.78 / $426.58	Professional		$147.91	$218.78	$426.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $177.83 / $251.19	Professional		$117.49	$177.83	$251.19