Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $4,677.35 / $18,620.87	Facility		$398.11	$4,677.35	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $281.84 / $977.24	Professional		$181.97	$281.84	$977.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $229.09 / $269.15	Professional		$190.55	$229.09	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $3,981.07	Facility		$2,398.83	$2,398.83	$3,981.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $467.74 / $707.95	Professional		$269.15	$467.74	$707.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $501.19 / $4,466.84	Facility		$281.84	$501.19	$4,466.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $489.78 / $1,778.28	Professional		$281.84	$489.78	$1,778.28
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 $323.59 / $436.52 / $512.86	Facility		$323.59	$436.52	$512.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $346.74 / $346.74	Facility		$338.84	$346.74	$346.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $524.81 / $691.83	Professional		$309.03	$524.81	$691.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,888.44 / $8,912.51 / $16,982.44	Facility		$5,888.44	$8,912.51	$16,982.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $446.68 / $630.96	Professional		$309.03	$446.68	$630.96
United Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $11,220.18 / $19,498.45	Facility		$1,995.26	$11,220.18	$19,498.45
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $363.08 / $676.08	Professional		$245.47	$363.08	$676.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $281.84 / $380.19	Professional		$199.53	$281.84	$380.19