Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $2,290.87 / $9,772.37	Facility		$199.53	$2,290.87	$9,772.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $208.93 / $602.56	Professional		$123.03	$208.93	$602.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $213.80 / $213.80	Professional		$186.21	$213.80	$213.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $295.12 / $724.44	Facility		$194.98	$295.12	$724.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $302.00 / $537.03	Professional		$190.55	$302.00	$537.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $346.74 / $562.34	Facility		$199.53	$346.74	$562.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $346.74 / $501.19	Professional		$213.80	$346.74	$501.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $102.33	Professional		$32.36	$33.11	$102.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $380.19 / $416.87	Facility		$251.19	$380.19	$416.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $275.42 / $281.84	Facility		$151.36	$275.42	$281.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $371.54 / $524.81	Professional		$218.78	$371.54	$524.81
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 $208.93 / $309.03 / $436.52	Professional		$208.93	$309.03	$436.52
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 $190.55 / $263.03 / $537.03	Professional		$190.55	$263.03	$537.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $213.80 / $302.00	Professional		$144.54	$213.80	$302.00