Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $1,348.96 / $18,620.87	Facility		$213.80	$1,348.96	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $380.19 / $1,023.29	Professional		$107.15	$380.19	$1,023.29
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $239.88 / $588.84 / $977.24	Professional	50	$239.88	$588.84	$977.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Professional		$61.66	$61.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $398.11 / $1,412.54	Professional		$131.83	$398.11	$1,412.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $389.05 / $1,288.25	Facility		$151.36	$389.05	$1,288.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $389.05 / $1,258.93	Professional		$144.54	$389.05	$1,258.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $89.13	Professional		$32.36	$33.11	$89.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $977.24 / $1,071.52	Facility		$660.69	$977.24	$1,071.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $758.58	Facility		$724.44	$724.44	$758.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $676.08 / $1,412.54	Professional		$165.96	$676.08	$1,412.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $398.11 / $1,202.26	Professional		$181.97	$398.11	$1,202.26
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $660.69 / $6,165.95	Facility		$416.87	$660.69	$6,165.95
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $446.68 / $1,230.27	Professional		$131.83	$446.68	$1,230.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $177.83 / $758.58	Professional		$93.33	$177.83	$758.58