Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $316.23 / $13,803.84	Facility		$147.91	$316.23	$13,803.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $120.23 / $354.81	Professional		$74.13	$120.23	$354.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $204.17 / $229.09	Professional		$134.90	$204.17	$229.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $501.19 / $870.96	Facility		$190.55	$501.19	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $154.88 / $331.13	Professional		$89.13	$154.88	$331.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $141.25 / $288.40	Facility		$89.13	$141.25	$288.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $141.25 / $257.04	Professional		$89.13	$141.25	$257.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $204.17 / $239.88	Facility		$141.25	$204.17	$239.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $162.18	Facility		$158.49	$158.49	$162.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $194.98 / $295.12	Professional		$112.20	$194.98	$295.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $691.83 / $1,288.25	Facility		$512.86	$691.83	$1,288.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $169.82 / $263.03	Professional		$107.15	$169.82	$263.03
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $912.01 / $1,949.84	Facility		$416.87	$912.01	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $141.25 / $269.15	Professional		$93.33	$141.25	$269.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $128.82 / $181.97	Professional		$74.13	$128.82	$181.97