Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $616.60 / $9,772.37	Facility		$288.40	$616.60	$9,772.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $275.42 / $645.65	Professional		$190.55	$275.42	$645.65
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $239.88 / $380.19 / $933.25	Professional	54	$239.88	$380.19	$933.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $436.52 / $446.68	Professional		$169.82	$436.52	$446.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Facility		$302.00	$302.00	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $363.08 / $691.83	Professional		$199.53	$363.08	$691.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $309.03 / $562.34	Facility		$194.98	$309.03	$562.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $316.23 / $549.54	Professional		$194.98	$316.23	$549.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $134.90	Professional		$32.36	$33.11	$134.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $416.87 / $457.09	Facility		$302.00	$416.87	$457.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $295.12 / $309.03	Facility		$234.42	$295.12	$309.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $457.09 / $616.60	Professional		$288.40	$457.09	$616.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $660.69 / $1,288.25	Facility		$436.52	$660.69	$1,288.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $407.38 / $549.54	Professional		$281.84	$407.38	$549.54
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 $234.42 / $316.23 / $575.44	Professional		$234.42	$316.23	$575.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $281.84 / $407.38	Professional		$213.80	$281.84	$407.38