Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $4,570.88 / $8,709.64	Facility		$812.83	$4,570.88	$8,709.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $660.69 / $2,570.40	Professional		$275.42	$660.69	$2,570.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $478.63 / $741.31	Professional		$234.42	$478.63	$741.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $676.08 / $1,995.26	Facility		$630.96	$676.08	$1,995.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $676.08 / $1,621.81	Professional		$323.59	$676.08	$1,621.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $741.31 / $1,621.81	Facility		$380.19	$741.31	$1,621.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $741.31 / $1,513.56	Professional		$380.19	$741.31	$1,513.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $158.49	Professional		$32.36	$33.11	$158.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,071.52 / $1,202.26	Facility		$724.44	$1,071.52	$1,202.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Facility		$812.83	$812.83	$812.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $812.83 / $1,479.11	Professional		$426.58	$812.83	$1,479.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $4,570.88 / $8,709.64	Facility		$3,311.31	$4,570.88	$8,709.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $812.83 / $1,348.96	Professional		$398.11	$812.83	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $5,623.41 / $9,120.11	Facility		$1,122.02	$5,623.41	$9,120.11
United Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $691.83 / $1,348.96	Professional		$354.81	$691.83	$1,348.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $562.34 / $912.01	Professional		$295.12	$562.34	$912.01