Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Facility		$575.44	$575.44	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $457.09 / $575.44	Professional		$389.05	$457.09	$575.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Professional		$426.58	$426.58	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $912.01 / $1,479.11	Professional		$512.86	$912.01	$1,479.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $537.03 / $954.99	Facility		$302.00	$537.03	$954.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $512.86 / $891.25	Professional		$323.59	$512.86	$891.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $50.12 / $549.54	Professional		$33.11	$50.12	$549.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $389.05 / $407.38	Facility		$323.59	$389.05	$407.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $562.34 / $645.65	Facility		$562.34	$562.34	$645.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $912.01 / $1,348.96	Professional		$645.65	$912.01	$1,348.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $891.25 / $1,698.24	Facility		$645.65	$891.25	$1,698.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $851.14 / $1,122.02	Professional		$537.03	$851.14	$1,122.02
United Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $812.83 / $1,479.11	Facility		$602.56	$812.83	$1,479.11
United Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $691.83 / $1,174.90	Professional		$436.52	$691.83	$1,174.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $467.74 / $776.25	Professional		$407.38	$467.74	$776.25