Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $1,659.59 / $14,791.08	Facility		$575.44	$1,659.59	$14,791.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $407.38 / $1,348.96	Professional		$208.93	$407.38	$1,348.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $407.38 / $912.01	Professional		$257.04	$407.38	$912.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $645.65 / $1,122.02	Facility		$512.86	$645.65	$1,122.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $575.44 / $1,096.48	Professional		$323.59	$575.44	$1,096.48
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $616.60 / $1,096.48	Facility		$380.19	$616.60	$1,096.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $616.60 / $1,071.52	Professional		$380.19	$616.60	$1,071.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $114.82	Professional		$32.36	$33.11	$114.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $812.83 / $851.14	Facility		$512.86	$812.83	$851.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $575.44 / $588.84	Facility		$354.81	$575.44	$588.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $630.96 / $1,071.52	Professional		$354.81	$630.96	$1,071.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,778.28 / $3,388.44	Facility		$1,202.26	$1,778.28	$3,388.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $575.44 / $870.96	Professional		$346.74	$575.44	$870.96
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 $331.13 / $537.03 / $1,071.52	Professional		$331.13	$537.03	$1,071.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $416.87 / $602.56	Professional		$218.78	$416.87	$602.56