Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $2,290.87 / $17,782.79	Facility		$134.90	$2,290.87	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $134.90 / $380.19	Professional		$67.61	$134.90	$380.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Professional		$257.04	$257.04	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $204.17 / $398.11	Professional		$107.15	$204.17	$398.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $190.55 / $1,380.38	Facility		$102.33	$190.55	$1,380.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $186.21 / $363.08	Professional		$104.71	$186.21	$363.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $44.67	Professional		$32.36	$33.11	$44.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $269.15 / $281.84	Facility		$181.97	$269.15	$281.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $194.98 / $371.54	Professional		$97.72	$194.98	$371.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $4,365.16 / $8,317.64	Facility		$2,884.03	$4,365.16	$8,317.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $181.97 / $338.84	Professional		$102.33	$181.97	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $5,754.40 / $9,332.54	Facility		$1,698.24	$5,754.40	$9,332.54
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $169.82 / $354.81	Professional		$87.10	$169.82	$354.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $117.49 / $204.17	Professional		$61.66	$117.49	$204.17