Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $389.05 / $794.33	Facility		$60.26	$389.05	$794.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $104.71 / $331.13	Professional		$51.29	$104.71	$331.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $158.49 / $186.21	Professional		$51.29	$158.49	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $147.91	Facility		$123.03	$123.03	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $107.15 / $229.09	Professional		$58.88	$107.15	$229.09
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $109.65 / $208.93	Facility		$69.18	$109.65	$208.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $107.15 / $199.53	Professional		$69.18	$107.15	$199.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $162.18 / $169.82	Facility		$120.23	$162.18	$169.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $114.82	Facility		$107.15	$107.15	$114.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $114.82 / $213.80	Professional		$60.26	$114.82	$213.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $446.68 / $851.14	Facility		$302.00	$446.68	$851.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $109.65 / $190.55	Professional		$56.23	$109.65	$190.55
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $616.60 / $1,513.56	Facility		$416.87	$616.60	$1,513.56
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $102.33 / $190.55	Professional		$54.95	$102.33	$190.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $70.79 / $141.25	Professional		$37.15	$70.79	$141.25