Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $645.65 / $17,782.79	Facility		$218.78	$645.65	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $162.18 / $416.87	Professional		$95.50	$162.18	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $177.83	Professional		$151.36	$151.36	$177.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $251.19	Facility		$165.96	$165.96	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $223.87 / $436.52	Professional		$134.90	$223.87	$436.52
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $251.19 / $436.52	Facility		$154.88	$251.19	$436.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $251.19 / $407.38	Professional		$154.88	$251.19	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $67.61	Professional		$32.36	$33.11	$67.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $309.03 / $338.84	Facility		$208.93	$309.03	$338.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $223.87 / $229.09	Facility		$112.20	$223.87	$229.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $257.04 / $416.87	Professional		$144.54	$257.04	$416.87
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 $141.25 / $223.87 / $331.13	Professional		$141.25	$223.87	$331.13
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 $131.83 / $208.93 / $407.38	Professional		$131.83	$208.93	$407.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $165.96 / $234.42	Professional		$91.20	$165.96	$234.42