Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $338.84 / $18,620.87	Facility		$213.80	$338.84	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $181.97 / $691.83	Professional		$112.20	$181.97	$691.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $223.87 / $316.23	Professional		$138.04	$223.87	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $257.04 / $407.38	Professional		$169.82	$257.04	$407.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $263.03 / $398.11	Facility		$147.91	$263.03	$398.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $263.03 / $363.08	Professional		$151.36	$263.03	$363.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $74.13	Professional		$32.36	$33.11	$74.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $269.15 / $295.12	Facility		$194.98	$269.15	$295.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $199.53	Facility		$190.55	$190.55	$199.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $269.15 / $371.54	Professional		$158.49	$269.15	$371.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $562.34 / $1,096.48	Facility		$371.54	$562.34	$1,096.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $234.42 / $338.84	Professional		$162.18	$234.42	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $758.58 / $1,905.46	Facility		$537.03	$758.58	$1,905.46
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $194.98 / $380.19	Professional		$138.04	$194.98	$380.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $147.91 / $208.93	Professional		$102.33	$147.91	$208.93