Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $1,513.56 / $9,772.37	Facility		$162.18	$1,513.56	$9,772.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $138.04 / $407.38	Professional		$70.79	$138.04	$407.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $269.15	Professional		$97.72	$97.72	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $213.80 / $724.44	Facility		$141.25	$213.80	$724.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $173.78 / $338.84	Professional		$104.71	$173.78	$338.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $199.53 / $354.81	Facility		$117.49	$199.53	$354.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $199.53 / $316.23	Professional		$117.49	$199.53	$316.23
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 $138.04 / $229.09 / $257.04	Facility		$138.04	$229.09	$257.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $173.78 / $177.83	Facility		$112.20	$173.78	$177.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $208.93 / $323.59	Professional		$117.49	$208.93	$323.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,995.26 / $3,801.89	Facility		$1,348.96	$1,995.26	$3,801.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $177.83 / $269.15	Professional		$112.20	$177.83	$269.15
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $2,454.71 / $4,786.30	Facility		$676.08	$2,454.71	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $162.18 / $316.23	Professional		$97.72	$162.18	$316.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $131.83 / $186.21	Professional		$77.62	$131.83	$186.21