Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $562.34 / $17,782.79	Facility		$57.54	$562.34	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $70.79 / $186.21	Professional		$25.70	$70.79	$186.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Professional		$91.20	$91.20	$91.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $151.36	Facility		$100.00	$100.00	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $81.28 / $234.42	Professional		$35.48	$81.28	$234.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $93.33 / $234.42	Facility		$45.71	$93.33	$234.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $85.11 / $218.78	Professional		$45.71	$85.11	$218.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $58.88	Professional		$32.36	$33.11	$58.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $134.90 / $181.97	Facility		$87.10	$134.90	$181.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $123.03 / $123.03	Facility		$79.43	$123.03	$123.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $95.50 / $223.87	Professional		$38.90	$95.50	$223.87
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 $38.90 / $93.33 / $186.21	Professional		$38.90	$93.33	$186.21
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 $38.02 / $85.11 / $204.17	Professional		$38.02	$85.11	$204.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $47.86 / $128.82	Professional		$25.12	$47.86	$128.82