Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $691.83 / $13,803.84	Facility		$85.11	$691.83	$13,803.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $102.33 / $269.15	Professional		$41.69	$102.33	$269.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $67.61 / $93.33	Professional		$64.57	$67.61	$93.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $162.18 / $870.96	Facility		$134.90	$162.18	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $128.82 / $263.03	Professional		$54.95	$128.82	$263.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $123.03 / $275.42	Facility		$56.23	$123.03	$275.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $120.23 / $239.88	Professional		$56.23	$120.23	$239.88
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 $151.36 / $181.97 / $239.88	Facility		$151.36	$181.97	$239.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $125.89 / $229.09	Professional		$64.57	$125.89	$229.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $851.14 / $1,621.81	Facility		$575.44	$851.14	$1,621.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $123.03 / $218.78	Professional		$61.66	$123.03	$218.78
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $1,071.52 / $2,454.71	Facility		$416.87	$1,071.52	$2,454.71
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $117.49 / $234.42	Professional		$57.54	$117.49	$234.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $75.86 / $141.25	Professional		$39.81	$75.86	$141.25