Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $389.05 / $1,000.00	Facility		$102.33	$389.05	$1,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $109.65 / $251.19	Professional		$57.54	$109.65	$251.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $38.02 / $67.61	Professional		$25.70	$38.02	$67.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $288.40 / $562.34	Facility		$87.10	$288.40	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $223.87 / $398.11	Professional		$87.10	$223.87	$398.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $177.83 / $331.13	Facility		$93.33	$177.83	$331.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $186.21 / $338.84	Professional		$97.72	$186.21	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $44.67 / $54.95	Professional		$20.89	$44.67	$54.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $251.19 / $257.04	Facility		$208.93	$251.19	$257.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $173.78	Facility		$169.82	$169.82	$173.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $281.84 / $371.54	Professional		$173.78	$281.84	$371.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $269.15 / $363.08	Professional		$173.78	$269.15	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $123.03 / $295.12	Professional		$63.10	$123.03	$295.12