Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $218.78 / $302.00	Facility		$125.89	$218.78	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $158.49 / $426.58	Professional		$91.20	$158.49	$426.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $128.82 / $229.09	Professional		$100.00	$128.82	$229.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Facility		$144.54	$144.54	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $162.18 / $316.23	Professional		$95.50	$162.18	$316.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $134.90 / $263.03	Facility		$81.28	$134.90	$263.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $134.90 / $251.19	Professional		$81.28	$134.90	$251.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $120.23 / $239.88	Professional		$60.26	$120.23	$239.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $245.47 / $257.04	Facility		$177.83	$245.47	$257.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $199.53 / $323.59	Professional		$138.04	$199.53	$323.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Facility		$269.15	$269.15	$269.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $181.97 / $275.42	Professional		$128.82	$181.97	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $158.49 / $263.03	Professional		$97.72	$158.49	$263.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $134.90 / $194.98	Professional		$83.18	$134.90	$194.98