Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $870.96 / $2,884.03	Facility		$213.80	$870.96	$2,884.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $223.87 / $645.65	Professional		$141.25	$223.87	$645.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $263.03 / $616.60	Professional		$234.42	$263.03	$616.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $707.95 / $1,258.93	Facility		$257.04	$707.95	$1,258.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $380.19 / $575.44	Professional		$239.88	$380.19	$575.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $416.87 / $1,174.90	Facility		$245.47	$416.87	$1,174.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $407.38 / $549.54	Professional		$245.47	$407.38	$549.54
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 $281.84 / $331.13 / $407.38	Facility		$281.84	$331.13	$407.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $245.47	Facility		$239.88	$239.88	$245.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $389.05 / $489.78	Professional		$239.88	$389.05	$489.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $741.31 / $1,445.44	Facility		$467.74	$741.31	$1,445.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $380.19 / $512.86	Professional		$245.47	$380.19	$512.86
United Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,445.44 / $2,630.27	Facility		$1,071.52	$1,445.44	$2,630.27
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $245.47 / $478.63	Professional		$190.55	$245.47	$478.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $436.52 / $616.60	Professional		$323.59	$436.52	$616.60