Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $181.97 / $489.78	Facility		$95.50	$181.97	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $95.50 / $316.23	Professional		$57.54	$95.50	$316.23
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $85.11 / $85.11 / $144.54	Professional	CQ	$85.11	$85.11	$144.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $107.15 / $151.36	Facility		$89.13	$107.15	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $107.15 / $281.84	Professional		$72.44	$107.15	$281.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $109.65 / $257.04	Facility		$72.44	$109.65	$257.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $109.65 / $229.09	Professional		$72.44	$109.65	$229.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $66.07	Professional		$32.36	$33.11	$66.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $190.55 / $199.53	Facility		$131.83	$190.55	$199.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $190.55 / $275.42	Facility		$125.89	$190.55	$275.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $177.83 / $251.19	Professional		$102.33	$177.83	$251.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $151.36 / $288.40	Facility		$125.89	$151.36	$288.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $104.71 / $141.25	Professional		$97.72	$104.71	$141.25
United Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $87.10 / $218.78	Professional		$77.62	$87.10	$218.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $109.65 / $190.55	Professional		$100.00	$109.65	$190.55