Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $1,737.80 / $13,803.84	Facility		$229.09	$1,737.80	$13,803.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $213.80 / $602.56	Professional		$117.49	$213.80	$602.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $354.81	Professional		$165.96	$165.96	$354.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $302.00	Facility		$177.83	$177.83	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $316.23 / $537.03	Professional		$162.18	$316.23	$537.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $288.40 / $1,737.80	Facility		$158.49	$288.40	$1,737.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $275.42 / $467.74	Professional		$158.49	$275.42	$467.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $316.23 / $389.05	Facility		$190.55	$316.23	$389.05
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Facility		$263.03	$263.03	$263.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $331.13 / $489.78	Professional		$186.21	$331.13	$489.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $5,128.61 / $10,000.00	Facility		$3,801.89	$5,128.61	$10,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $288.40 / $436.52	Professional		$181.97	$288.40	$436.52
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $7,244.36 / $12,302.69	Facility		$1,698.24	$7,244.36	$12,302.69
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $223.87 / $467.74	Professional		$147.91	$223.87	$467.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $190.55 / $269.15	Professional		$123.03	$190.55	$269.15