Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $891.25 / $17,782.79	Facility		$208.93	$891.25	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $173.78 / $588.84	Professional		$117.49	$173.78	$588.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $338.84 / $371.54	Professional		$223.87	$338.84	$371.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Facility		$213.80	$213.80	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $295.12 / $501.19	Professional		$186.21	$295.12	$501.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $281.84 / $645.65	Facility		$158.49	$281.84	$645.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $269.15 / $426.58	Professional		$158.49	$269.15	$426.58
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 $223.87 / $323.59 / $363.08	Facility		$223.87	$323.59	$363.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $245.47	Facility		$239.88	$239.88	$245.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $302.00 / $446.68	Professional		$169.82	$302.00	$446.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $2,290.87 / $4,365.16	Facility		$1,479.11	$2,290.87	$4,365.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $269.15 / $416.87	Professional		$181.97	$269.15	$416.87
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $3,388.44 / $5,495.41	Facility		$933.25	$3,388.44	$5,495.41
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $234.42 / $446.68	Professional		$154.88	$234.42	$446.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $186.21 / $263.03	Professional		$107.15	$186.21	$263.03