Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $707.95 / $10,232.93	Facility		$208.93	$707.95	$10,232.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $204.17 / $588.84	Professional		$107.15	$204.17	$588.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $380.19 / $398.11	Professional		$218.78	$380.19	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $467.74 / $630.96	Facility		$186.21	$467.74	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $257.04 / $524.81	Professional		$128.82	$257.04	$524.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $257.04 / $524.81	Facility		$138.04	$257.04	$524.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $239.88 / $457.09	Professional		$128.82	$239.88	$457.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $123.03	Professional		$32.36	$33.11	$123.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $338.84 / $416.87	Facility		$245.47	$338.84	$416.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $288.40 / $288.40	Facility		$173.78	$288.40	$288.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $288.40 / $524.81	Professional		$154.88	$288.40	$524.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $707.95 / $1,348.96	Facility		$512.86	$707.95	$1,348.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $288.40 / $446.68	Professional		$173.78	$288.40	$446.68
United Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $870.96 / $1,995.26	Facility		$269.15	$870.96	$1,995.26
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $213.80 / $389.05	Professional		$117.49	$213.80	$389.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $204.17 / $331.13	Professional		$109.65	$204.17	$331.13