Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $371.54 / $645.65	Facility		$239.88	$371.54	$645.65
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $2,691.53 / $4,168.69 / $9,120.11	Facility	25	$2,691.53	$4,168.69	$9,120.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $251.19 / $812.83	Professional		$173.78	$251.19	$812.83
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $190.55 / $331.13 / $1,023.29	Professional	25	$190.55	$331.13	$1,023.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $331.13 / $575.44	Professional		$194.98	$331.13	$575.44
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $186.21 / $331.13 / $562.34	Professional	25	$186.21	$331.13	$562.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $10,715.19 / $11,220.18	Facility		$331.13	$10,715.19	$11,220.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $389.05 / $724.44	Professional		$234.42	$389.05	$724.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $380.19 / $758.58	Facility		$229.09	$380.19	$758.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $354.81 / $602.56	Professional		$218.78	$354.81	$602.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $213.80	Professional		$32.36	$33.11	$213.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $524.81 / $549.54	Facility		$371.54	$524.81	$549.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $489.78 / $707.95	Professional		$316.23	$489.78	$707.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $446.68 / $630.96	Professional		$295.12	$446.68	$630.96
United Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $3,019.95 / $4,168.69	Facility		$2,818.38	$3,019.95	$4,168.69
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $354.81 / $588.84	Professional		$229.09	$354.81	$588.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $316.23 / $446.68	Professional		$199.53	$316.23	$446.68