Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $1,288.25 / $10,232.93	Facility		$173.78	$1,288.25	$10,232.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $190.55 / $524.81	Professional		$79.43	$190.55	$524.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $151.36	Professional		$69.18	$69.18	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $218.78 / $501.19	Professional		$95.50	$218.78	$501.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $208.93 / $467.74	Facility		$117.49	$208.93	$467.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $208.93 / $467.74	Professional		$107.15	$208.93	$467.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $363.08 / $380.19	Facility		$257.04	$363.08	$380.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $263.03	Facility		$257.04	$257.04	$263.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $257.04 / $501.19	Professional		$128.82	$257.04	$501.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $257.04 / $436.52	Professional		$138.04	$257.04	$436.52
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $660.69 / $6,165.95	Facility		$416.87	$660.69	$6,165.95
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $213.80 / $467.74	Professional		$97.72	$213.80	$467.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $138.04 / $263.03	Professional		$72.44	$138.04	$263.03