Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $1,412.54 / $7,943.28	Facility		$302.00	$1,412.54	$7,943.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $257.04 / $851.14	Professional		$134.90	$257.04	$851.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $309.03 / $575.44	Professional		$218.78	$309.03	$575.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $426.58	Facility		$281.84	$281.84	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $338.84 / $691.83	Professional		$190.55	$338.84	$691.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $363.08 / $691.83	Facility		$229.09	$363.08	$691.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $371.54 / $645.65	Professional		$229.09	$371.54	$645.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $97.72	Professional		$32.36	$33.11	$97.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $446.68 / $524.81	Facility		$288.40	$446.68	$524.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $354.81 / $363.08	Facility		$229.09	$354.81	$363.08
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $380.19 / $660.69	Professional		$208.93	$380.19	$660.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,122.02 / $2,137.96	Facility		$776.25	$1,122.02	$2,137.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $354.81 / $537.03	Professional		$204.17	$354.81	$537.03
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 $190.55 / $316.23 / $630.96	Professional		$190.55	$316.23	$630.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $257.04 / $380.19	Professional		$134.90	$257.04	$380.19