Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $194.98 / $257.04	Facility		$120.23	$194.98	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $114.82 / $309.03	Professional		$72.44	$114.82	$309.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $151.36 / $323.59	Professional		$107.15	$151.36	$323.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $154.88 / $275.42	Professional		$95.50	$154.88	$275.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $134.90 / $239.88	Facility		$87.10	$134.90	$239.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $131.83 / $229.09	Professional		$85.11	$131.83	$229.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $81.28 / $158.49	Professional		$50.12	$81.28	$158.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $223.87 / $234.42	Facility		$169.82	$223.87	$234.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Professional		$177.83	$177.83	$177.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Facility		$251.19	$251.19	$251.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $97.72	Professional		$75.86	$75.86	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $154.88 / $245.47	Professional		$100.00	$154.88	$245.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $117.49 / $169.82	Professional		$89.13	$117.49	$169.82