Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $977.24 / $17,782.79	Facility		$213.80	$977.24	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $162.18 / $446.68	Professional		$107.15	$162.18	$446.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $181.97	Professional		$87.10	$87.10	$181.97
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 $131.83 / $223.87 / $446.68	Professional		$131.83	$223.87	$446.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $194.98 / $398.11	Facility		$125.89	$194.98	$398.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $194.98 / $354.81	Professional		$125.89	$194.98	$354.81
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 $213.80 / $295.12 / $323.59	Facility		$213.80	$295.12	$323.59
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $213.80 / $223.87	Facility		$186.21	$213.80	$223.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $281.84 / $407.38	Professional		$165.96	$281.84	$407.38
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 $158.49 / $245.47 / $371.54	Professional		$158.49	$245.47	$371.54
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 $134.90 / $204.17 / $389.05	Professional		$134.90	$204.17	$389.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $173.78 / $245.47	Professional		$102.33	$173.78	$245.47