Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $269.15 / $4,677.35	Facility		$74.13	$269.15	$4,677.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $125.89 / $446.68	Professional		$54.95	$125.89	$446.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $93.33 / $151.36	Professional		$69.18	$93.33	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $147.91 / $302.00	Professional		$72.44	$147.91	$302.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $165.96 / $323.59	Facility		$87.10	$165.96	$323.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $151.36 / $288.40	Professional		$87.10	$151.36	$288.40
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 $154.88 / $218.78 / $239.88	Facility		$154.88	$218.78	$239.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $162.18	Facility		$158.49	$158.49	$162.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $162.18 / $295.12	Professional		$79.43	$162.18	$295.12
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 $79.43 / $147.91 / $239.88	Professional		$79.43	$147.91	$239.88
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 $77.62 / $151.36 / $295.12	Professional		$77.62	$151.36	$295.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $104.71 / $208.93	Professional		$54.95	$104.71	$208.93