Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $162.18 / $416.87	Facility		$66.07	$162.18	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $63.10 / $181.97	Professional		$48.98	$63.10	$181.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $70.79 / $141.25	Professional		$32.36	$70.79	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $154.88 / $251.19	Facility		$72.44	$154.88	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $79.43 / $102.33	Professional		$43.65	$79.43	$102.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $100.00 / $204.17	Facility		$70.79	$100.00	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $100.00 / $213.80	Professional		$70.79	$100.00	$213.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $67.61 / $75.86	Professional		$61.66	$67.61	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $70.79 / $131.83	Facility		$70.79	$70.79	$131.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $123.03 / $208.93	Facility		$70.79	$123.03	$208.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $85.11	Professional		$63.10	$63.10	$85.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $104.71 / $194.98	Facility		$74.13	$104.71	$194.98
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $63.10 / $81.28	Professional		$60.26	$63.10	$81.28
United Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $85.11 / $85.11	Facility		$70.79	$85.11	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $40.74 / $79.43	Professional		$29.51	$40.74	$79.43