Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $3,467.37 / $18,620.87	Facility		$141.25	$3,467.37	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $131.83 / $380.19	Professional		$66.07	$131.83	$380.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $107.15	Professional		$102.33	$102.33	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $151.36 / $223.87	Professional		$97.72	$151.36	$223.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $151.36 / $190.55	Facility		$93.33	$151.36	$190.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $158.49 / $190.55	Professional		$95.50	$158.49	$190.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $144.54 / $151.36	Facility		$112.20	$144.54	$151.36
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Facility		$102.33	$102.33	$102.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $173.78 / $218.78	Professional		$102.33	$173.78	$218.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $147.91 / $194.98	Professional		$102.33	$147.91	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,454.71 / $37,153.52	Facility		$707.95	$2,454.71	$37,153.52
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $120.23 / $218.78	Professional		$74.13	$120.23	$218.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $87.10 / $123.03	Professional		$64.57	$87.10	$123.03