Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $831.76 / $10,232.93	Facility		$194.98	$831.76	$10,232.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $263.03 / $707.95	Professional		$104.71	$263.03	$707.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $165.96	Facility		$100.00	$100.00	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $346.74 / $977.24	Professional		$165.96	$346.74	$977.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $269.15 / $812.83	Facility		$125.89	$269.15	$812.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $269.15 / $870.96	Professional		$134.90	$269.15	$870.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $66.07	Professional		$32.36	$33.11	$66.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $575.44 / $707.95	Facility		$354.81	$575.44	$707.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Facility		$478.63	$478.63	$478.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $371.54 / $912.01	Professional		$147.91	$371.54	$912.01
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $363.08 / $691.83	Facility		$239.88	$363.08	$691.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $323.59 / $851.14	Professional		$151.36	$323.59	$851.14
United Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $524.81 / $1,862.09	Facility		$371.54	$524.81	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $309.03 / $870.96	Professional		$138.04	$309.03	$870.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $186.21 / $575.44	Professional		$97.72	$186.21	$575.44