Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $831.76 / $17,782.79	Facility		$199.53	$831.76	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $158.49 / $537.03	Professional		$100.00	$158.49	$537.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Professional		$234.42	$234.42	$234.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $478.63	Facility		$177.83	$177.83	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $190.55 / $371.54	Professional		$120.23	$190.55	$371.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $169.82 / $331.13	Facility		$97.72	$169.82	$331.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $177.83 / $309.03	Professional		$97.72	$177.83	$309.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $66.07	Professional		$32.36	$33.11	$66.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $245.47 / $257.04	Facility		$177.83	$245.47	$257.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $169.82 / $177.83	Facility		$81.28	$169.82	$177.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $245.47 / $323.59	Professional		$144.54	$245.47	$323.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $831.76 / $1,584.89	Facility		$602.56	$831.76	$1,584.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $239.88 / $331.13	Professional		$173.78	$239.88	$331.13
United Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $1,096.48 / $2,511.89	Facility		$154.88	$1,096.48	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $173.78 / $323.59	Professional		$125.89	$173.78	$323.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $154.88 / $257.04	Professional		$17.38	$154.88	$257.04