Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $1,737.80 / $18,620.87	Facility		$125.89	$1,737.80	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $204.17 / $707.95	Professional		$75.86	$204.17	$707.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Professional		$81.28	$81.28	$81.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $870.96	Facility		$120.23	$120.23	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $204.17 / $489.78	Professional		$87.10	$204.17	$489.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $199.53 / $436.52	Facility		$85.11	$199.53	$436.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $199.53 / $446.68	Professional		$85.11	$199.53	$446.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $42.66	Professional		$32.36	$33.11	$42.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $331.13 / $380.19	Facility		$281.84	$331.13	$380.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $234.42	Facility		$229.09	$229.09	$234.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $234.42 / $467.74	Professional		$104.71	$234.42	$467.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $199.53 / $426.58	Professional		$117.49	$199.53	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $645.65 / $5,754.40	Facility		$295.12	$645.65	$5,754.40
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $199.53 / $416.87	Professional		$87.10	$199.53	$416.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $117.49 / $245.47	Professional		$61.66	$117.49	$245.47