Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $3,801.89 / $13,803.84	Facility		$218.78	$3,801.89	$13,803.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $218.78 / $501.19	Professional		$87.10	$218.78	$501.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Professional		$158.49	$158.49	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $316.23 / $724.44	Professional		$154.88	$316.23	$724.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $338.84 / $776.25	Facility		$154.88	$338.84	$776.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $269.15 / $660.69	Professional		$158.49	$269.15	$660.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $61.66	Professional		$32.36	$33.11	$61.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $501.19 / $512.86	Facility		$371.54	$501.19	$512.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $354.81 / $354.81	Facility		$354.81	$354.81	$354.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $338.84 / $676.08	Professional		$138.04	$338.84	$676.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,995.26 / $3,801.89	Facility		$1,348.96	$1,995.26	$3,801.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $309.03 / $630.96	Professional		$147.91	$309.03	$630.96
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $2,630.27 / $4,897.79	Facility		$933.25	$2,630.27	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $288.40 / $676.08	Professional		$131.83	$288.40	$676.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $158.49 / $363.08	Professional		$83.18	$158.49	$363.08