Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $501.19 / $7,943.28	Facility		$104.71	$501.19	$7,943.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $91.20 / $281.84	Professional		$48.98	$91.20	$281.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Professional		$194.98	$194.98	$194.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $724.44	Facility		$416.87	$416.87	$724.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $114.82 / $223.87	Professional		$70.79	$114.82	$223.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $134.90 / $234.42	Facility		$79.43	$134.90	$234.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $128.82 / $218.78	Professional		$79.43	$128.82	$218.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $154.88 / $173.78	Facility		$104.71	$154.88	$173.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $117.49	Facility		$114.82	$114.82	$117.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $138.04 / $213.80	Professional		$77.62	$138.04	$213.80
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 $74.13 / $114.82 / $177.83	Professional		$74.13	$114.82	$177.83
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 $69.18 / $107.15 / $208.93	Professional		$69.18	$107.15	$208.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $95.50 / $134.90	Professional		$54.95	$95.50	$134.90