Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $2,089.30 / $10,232.93	Facility		$302.00	$2,089.30	$10,232.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $234.42 / $616.60	Professional		$138.04	$234.42	$616.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $302.00 / $478.63	Professional		$213.80	$302.00	$478.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $724.44 / $1,659.59	Facility		$416.87	$724.44	$1,659.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $316.23 / $575.44	Professional		$204.17	$316.23	$575.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $407.38 / $1,905.46	Facility		$245.47	$407.38	$1,905.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $407.38 / $912.01	Professional		$245.47	$407.38	$912.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $107.15	Professional		$32.36	$33.11	$107.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $426.58 / $1,047.13	Facility		$302.00	$426.58	$1,047.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $309.03 / $501.19	Facility		$302.00	$309.03	$501.19
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $389.05 / $562.34	Professional		$229.09	$389.05	$562.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $4,570.88 / $8,709.64	Facility		$3,235.94	$4,570.88	$8,709.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $323.59 / $478.63	Professional		$223.87	$323.59	$478.63
United Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $5,754.40 / $9,332.54	Facility		$1,047.13	$5,754.40	$9,332.54
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $288.40 / $575.44	Professional		$194.98	$288.40	$575.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $234.42 / $331.13	Professional		$154.88	$234.42	$331.13