Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $331.13 / $17,782.79	Facility		$57.54	$331.13	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $79.43 / $354.81	Professional		$25.12	$79.43	$354.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $50.12 / $162.18	Professional		$27.54	$50.12	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $1,122.02	Facility		$645.65	$645.65	$1,122.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $72.44 / $154.88	Professional		$32.36	$72.44	$154.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $74.13 / $151.36	Facility		$40.74	$74.13	$151.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $74.13 / $151.36	Professional		$40.74	$74.13	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $38.90	Professional		$32.36	$33.11	$38.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $114.82 / $120.23	Facility		$69.18	$114.82	$120.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $81.28	Facility		$79.43	$79.43	$81.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $75.86 / $147.91	Professional		$34.67	$75.86	$147.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $69.18 / $120.23	Professional		$34.67	$69.18	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $645.65 / $5,754.40	Facility		$141.25	$645.65	$5,754.40
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $72.44 / $151.36	Professional		$33.88	$72.44	$151.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $40.74 / $87.10	Professional		$21.38	$40.74	$87.10