Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $331.13 / $18,620.87	Facility		$112.20	$331.13	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $128.82 / $575.44	Professional		$53.70	$128.82	$575.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $281.84 / $295.12	Professional		$234.42	$281.84	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $169.82 / $363.08	Professional		$75.86	$169.82	$363.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $181.97 / $380.19	Facility		$89.13	$181.97	$380.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $165.96 / $354.81	Professional		$95.50	$165.96	$354.81
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 $131.83 / $263.03 / $275.42	Facility		$131.83	$263.03	$275.42
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Facility		$186.21	$186.21	$186.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $177.83 / $346.74	Professional		$81.28	$177.83	$346.74
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 $81.28 / $162.18 / $281.84	Professional		$81.28	$162.18	$281.84
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 $77.62 / $151.36 / $346.74	Professional		$77.62	$151.36	$346.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $93.33 / $190.55	Professional		$48.98	$93.33	$190.55