Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $1,513.56 / $9,772.37	Facility		$204.17	$1,513.56	$9,772.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $158.49 / $489.78	Professional		$70.79	$158.49	$489.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $154.88 / $323.59	Professional		$79.43	$154.88	$323.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $245.47 / $724.44	Facility		$162.18	$245.47	$724.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $213.80 / $407.38	Professional		$131.83	$213.80	$407.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $245.47 / $416.87	Facility		$144.54	$245.47	$416.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $245.47 / $380.19	Professional		$147.91	$245.47	$380.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $69.18	Professional		$32.36	$33.11	$69.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $269.15 / $316.23	Facility		$158.49	$269.15	$316.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $213.80 / $213.80	Facility		$128.82	$213.80	$213.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $257.04 / $389.05	Professional		$144.54	$257.04	$389.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,122.02 / $2,137.96	Facility		$831.76	$1,122.02	$2,137.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $213.80 / $331.13	Professional		$144.54	$213.80	$331.13
United Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $1,513.56 / $3,235.94	Facility		$501.19	$1,513.56	$3,235.94
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $194.98 / $398.11	Professional		$125.89	$194.98	$398.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $158.49 / $223.87	Professional		$95.50	$158.49	$223.87