Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $467.74 / $11,481.54	Facility		$186.21	$467.74	$11,481.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $181.97 / $630.96	Professional		$112.20	$181.97	$630.96
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $794.33 / $794.33 / $794.33	Professional	22	$794.33	$794.33	$794.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $269.15 / $436.52	Professional		$125.89	$269.15	$436.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $263.03 / $724.44	Facility		$173.78	$263.03	$724.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $218.78 / $436.52	Professional		$125.89	$218.78	$436.52
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $239.88 / $436.52	Facility		$151.36	$239.88	$436.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $234.42 / $407.38	Professional		$151.36	$234.42	$407.38
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 $204.17 / $302.00 / $338.84	Facility		$204.17	$302.00	$338.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $229.09 / $229.09	Facility		$141.25	$229.09	$229.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $245.47 / $426.58	Professional		$134.90	$245.47	$426.58
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 $131.83 / $229.09 / $338.84	Professional		$131.83	$229.09	$338.84
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 $125.89 / $204.17 / $407.38	Professional		$125.89	$204.17	$407.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $158.49 / $234.42	Professional		$85.11	$158.49	$234.42