Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $977.24 / $6,456.54	Facility		$173.78	$977.24	$6,456.54
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $870.96 / $870.96 / $870.96	Facility	52	$870.96	$870.96	$870.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $158.49 / $537.03	Professional		$91.20	$158.49	$537.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $173.78 / $239.88	Professional		$104.71	$173.78	$239.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $190.55	Facility		$125.89	$125.89	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $186.21 / $338.84	Professional		$123.03	$186.21	$338.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $213.80 / $354.81	Facility		$125.89	$213.80	$354.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $213.80 / $323.59	Professional		$128.82	$213.80	$323.59
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 $120.23 / $213.80 / $263.03	Facility		$120.23	$213.80	$263.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $173.78 / $177.83	Facility		$100.00	$173.78	$177.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $229.09 / $323.59	Professional		$131.83	$229.09	$323.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,122.02 / $2,137.96	Facility		$776.25	$1,122.02	$2,137.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $186.21 / $275.42	Professional		$128.82	$186.21	$275.42
United Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $1,513.56 / $3,235.94	Facility		$501.19	$1,513.56	$3,235.94
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $165.96 / $338.84	Professional		$120.23	$165.96	$338.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $134.90 / $190.55	Professional		$93.33	$134.90	$190.55