Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $288.40 / $371.54	Facility		$177.83	$288.40	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $165.96 / $562.34	Professional		$112.20	$165.96	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $177.83 / $331.13	Professional		$151.36	$177.83	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $229.09 / $398.11	Professional		$147.91	$229.09	$398.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $213.80 / $354.81	Facility		$134.90	$213.80	$354.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $204.17 / $338.84	Professional		$134.90	$204.17	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $120.23 / $234.42	Professional		$77.62	$120.23	$234.42
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $316.23 / $346.74	Facility		$251.19	$316.23	$346.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Professional		$251.19	$251.19	$251.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Facility		$380.19	$380.19	$380.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $138.04	Professional		$114.82	$114.82	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $234.42 / $380.19	Professional		$151.36	$234.42	$380.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $165.96 / $257.04	Professional		$134.90	$165.96	$257.04