Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $1,318.26 / $10,232.93	Facility		$165.96	$1,318.26	$10,232.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $354.81 / $1,621.81	Professional		$74.13	$354.81	$1,621.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Professional		$138.04	$138.04	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $575.44 / $1,174.90	Professional		$128.82	$575.44	$1,174.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $245.47 / $1,174.90	Facility		$123.03	$245.47	$1,174.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $251.19 / $1,174.90	Professional		$131.83	$251.19	$1,174.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $50.12	Professional		$32.36	$33.11	$50.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $724.44 / $1,047.13	Facility		$602.56	$724.44	$1,047.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $549.54	Facility		$524.81	$524.81	$549.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $288.40 / $1,047.13	Professional		$112.20	$288.40	$1,047.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $263.03 / $977.24	Professional		$123.03	$263.03	$977.24
United Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $660.69 / $6,165.95	Facility		$190.55	$660.69	$6,165.95
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $363.08 / $1,122.02	Professional		$109.65	$363.08	$1,122.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $131.83 / $537.03	Professional		$69.18	$131.83	$537.03