Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $194.98 / $275.42	Facility		$144.54	$194.98	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $123.03 / $323.59	Professional		$74.13	$123.03	$323.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $128.82 / $218.78	Professional		$100.00	$128.82	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $147.91 / $281.84	Professional		$83.18	$147.91	$281.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $123.03 / $239.88	Facility		$72.44	$123.03	$239.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $120.23 / $229.09	Professional		$72.44	$120.23	$229.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $117.49 / $223.87	Professional		$58.88	$117.49	$223.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $229.09 / $239.88	Facility		$165.96	$229.09	$239.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Facility		$158.49	$158.49	$158.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $177.83 / $295.12	Professional		$120.23	$177.83	$295.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Facility		$245.47	$245.47	$245.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $162.18 / $251.19	Professional		$114.82	$162.18	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $141.25 / $239.88	Professional		$87.10	$141.25	$239.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $123.03 / $177.83	Professional		$74.13	$123.03	$177.83