Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $676.08 / $10,232.93	Facility		$199.53	$676.08	$10,232.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $169.82 / $549.54	Professional		$100.00	$169.82	$549.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $169.82 / $208.93	Professional		$83.18	$169.82	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $707.95 / $870.96	Facility		$199.53	$707.95	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $213.80 / $426.58	Professional		$125.89	$213.80	$426.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $186.21 / $380.19	Facility		$114.82	$186.21	$380.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $186.21 / $338.84	Professional		$114.82	$186.21	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $60.26	Professional		$32.36	$33.11	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $281.84 / $309.03	Facility		$199.53	$281.84	$309.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $204.17 / $208.93	Facility		$186.21	$204.17	$208.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $263.03 / $380.19	Professional		$154.88	$263.03	$380.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,949.84 / $3,715.35	Facility		$1,318.26	$1,949.84	$3,715.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $229.09 / $354.81	Professional		$147.91	$229.09	$354.81
United Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $2,454.71 / $4,786.30	Facility		$891.25	$2,454.71	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $194.98 / $363.08	Professional		$128.82	$194.98	$363.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $165.96 / $234.42	Professional		$95.50	$165.96	$234.42