Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,698.24 / $10,232.93	Facility		$100.00	$1,698.24	$10,232.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $100.00 / $288.40	Professional		$51.29	$100.00	$288.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $467.74 / $630.96	Facility		$151.36	$467.74	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $128.82 / $288.40	Professional		$64.57	$128.82	$288.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $134.90 / $302.00	Facility		$72.44	$134.90	$302.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $123.03 / $234.42	Professional		$66.07	$123.03	$234.42
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 $138.04 / $186.21 / $204.17	Facility		$138.04	$186.21	$204.17
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $131.83 / $134.90	Facility		$100.00	$131.83	$134.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $134.90 / $245.47	Professional		$74.13	$134.90	$245.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,995.26 / $3,801.89	Facility		$1,445.44	$1,995.26	$3,801.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $138.04 / $213.80	Professional		$83.18	$138.04	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $2,344.23 / $4,570.88	Facility		$602.56	$2,344.23	$4,570.88
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $109.65 / $199.53	Professional		$60.26	$109.65	$199.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $91.20 / $138.04	Professional		$48.98	$91.20	$138.04