Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $831.76 / $13,803.84	Facility		$275.42	$831.76	$13,803.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $204.17 / $512.86	Professional		$120.23	$204.17	$512.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $389.05	Facility		$234.42	$234.42	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $354.81 / $645.65	Professional		$213.80	$354.81	$645.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $338.84 / $588.84	Facility		$199.53	$338.84	$588.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $338.84 / $549.54	Professional		$199.53	$338.84	$549.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $407.38 / $457.09	Facility		$275.42	$407.38	$457.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $316.23	Facility		$302.00	$302.00	$316.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $380.19 / $575.44	Professional		$223.87	$380.19	$575.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $912.01 / $1,737.80	Facility		$660.69	$912.01	$1,737.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $323.59 / $489.78	Professional		$218.78	$323.59	$489.78
United Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,148.15 / $2,398.83	Facility		$645.65	$1,148.15	$2,398.83
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $269.15 / $537.03	Professional		$158.49	$269.15	$537.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $229.09 / $323.59	Professional		$128.82	$229.09	$323.59