Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $295.12 / $18,620.87	Facility		$91.20	$295.12	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $114.82 / $501.19	Professional		$46.77	$114.82	$501.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $112.20 / $123.03	Professional		$95.50	$112.20	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $144.54 / $323.59	Professional		$61.66	$144.54	$323.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $151.36 / $338.84	Facility		$75.86	$151.36	$338.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $134.90 / $309.03	Professional		$77.62	$134.90	$309.03
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 $117.49 / $223.87 / $245.47	Facility		$117.49	$223.87	$245.47
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $169.82	Facility		$165.96	$165.96	$169.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $154.88 / $309.03	Professional		$66.07	$154.88	$309.03
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 $66.07 / $141.25 / $251.19	Professional		$66.07	$141.25	$251.19
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 $64.57 / $128.82 / $302.00	Professional		$64.57	$128.82	$302.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $77.62 / $173.78	Professional		$40.74	$77.62	$173.78