Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $316.23 / $18,620.87	Facility		$117.49	$316.23	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $123.03 / $407.38	Professional		$56.23	$123.03	$407.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $138.04	Professional		$107.15	$107.15	$138.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $213.80	Facility		$138.04	$138.04	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $173.78 / $363.08	Professional		$79.43	$173.78	$363.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $181.97 / $363.08	Facility		$100.00	$181.97	$363.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $169.82 / $346.74	Professional		$100.00	$169.82	$346.74
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 / $234.42 / $281.84	Facility		$131.83	$234.42	$281.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $190.55 / $190.55	Facility		$112.20	$190.55	$190.55
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $181.97 / $346.74	Professional		$85.11	$181.97	$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 $85.11 / $165.96 / $288.40	Professional		$85.11	$165.96	$288.40
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 $81.28 / $158.49 / $354.81	Professional		$81.28	$158.49	$354.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $97.72 / $190.55	Professional		$51.29	$97.72	$190.55