Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $371.54 / $478.63	Facility		$269.15	$371.54	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $218.78 / $446.68	Professional		$186.21	$218.78	$446.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $234.42 / $407.38	Professional		$218.78	$234.42	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $346.74 / $616.60	Professional		$218.78	$346.74	$616.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $288.40 / $489.78	Facility		$181.97	$288.40	$489.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $275.42 / $467.74	Professional		$177.83	$275.42	$467.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $158.49	Professional		$32.36	$33.11	$158.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $407.38 / $416.87	Facility		$288.40	$407.38	$416.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $281.84	Facility		$275.42	$275.42	$281.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $407.38 / $588.84	Professional		$281.84	$407.38	$588.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $389.05 / $524.81	Professional		$251.19	$389.05	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $331.13 / $575.44	Professional		$223.87	$331.13	$575.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $239.88 / $338.84	Professional		$177.83	$239.88	$338.84