Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $229.09 / $363.08	Facility		$112.20	$229.09	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $131.83 / $213.80	Professional		$104.71	$131.83	$213.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $117.49 / $162.18	Professional		$95.50	$117.49	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $186.21 / $309.03	Professional		$107.15	$186.21	$309.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $138.04 / $204.17	Facility		$107.15	$138.04	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $138.04 / $194.98	Professional		$107.15	$138.04	$194.98
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 $181.97 / $251.19 / $295.12	Facility		$181.97	$251.19	$295.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $251.19 / $389.05	Professional		$151.36	$251.19	$389.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $354.81 / $549.54	Facility		$125.89	$354.81	$549.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $223.87	Professional		$128.82	$169.82	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $660.69 / $912.01	Facility		$602.56	$660.69	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $177.83 / $354.81	Professional		$109.65	$177.83	$354.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $173.78 / $251.19	Professional		$131.83	$173.78	$251.19