Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $1,000.00 / $17,782.79	Facility		$239.88	$1,000.00	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $177.83 / $426.58	Professional		$107.15	$177.83	$426.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17
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 $151.36 / $251.19 / $467.74	Professional		$151.36	$251.19	$467.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $275.42 / $489.78	Facility		$169.82	$275.42	$489.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $275.42 / $446.68	Professional		$169.82	$275.42	$446.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $338.84 / $363.08	Facility		$223.87	$338.84	$363.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $239.88 / $245.47	Facility		$138.04	$239.88	$245.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $288.40 / $446.68	Professional		$162.18	$288.40	$446.68
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 $158.49 / $245.47 / $371.54	Professional		$158.49	$245.47	$371.54
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 $151.36 / $229.09 / $446.68	Professional		$151.36	$229.09	$446.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $181.97 / $257.04	Professional		$100.00	$181.97	$257.04