Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $977.24 / $10,232.93	Facility		$213.80	$977.24	$10,232.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $204.17 / $588.84	Professional		$109.65	$204.17	$588.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Professional		$177.83	$177.83	$177.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $467.74 / $630.96	Facility		$204.17	$467.74	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $257.04 / $537.03	Professional		$131.83	$257.04	$537.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $275.42 / $616.60	Facility		$141.25	$275.42	$616.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $251.19 / $467.74	Professional		$131.83	$251.19	$467.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $125.89	Professional		$32.36	$33.11	$125.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $363.08 / $426.58	Facility		$245.47	$363.08	$426.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $295.12 / $295.12	Facility		$218.78	$295.12	$295.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $295.12 / $537.03	Professional		$158.49	$295.12	$537.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $3,388.44 / $6,456.54	Facility		$2,570.40	$3,388.44	$6,456.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $295.12 / $457.09	Professional		$177.83	$295.12	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $3,715.35 / $7,079.46	Facility		$933.25	$3,715.35	$7,079.46
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $213.80 / $398.11	Professional		$123.03	$213.80	$398.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $208.93 / $338.84	Professional		$109.65	$208.93	$338.84