Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $213.80 / $295.12	Facility		$64.57	$213.80	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $162.18 / $398.11	Professional		$87.10	$162.18	$398.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $128.82 / $218.78	Professional		$97.72	$128.82	$218.78
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 / $158.49 / $302.00	Professional		$95.50	$158.49	$302.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $134.90 / $251.19	Facility		$77.62	$134.90	$251.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $131.83 / $245.47	Professional		$81.28	$131.83	$245.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $91.20	Professional		$32.36	$50.12	$91.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $239.88 / $251.19	Facility		$173.78	$239.88	$251.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $190.55 / $309.03	Professional		$134.90	$190.55	$309.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Facility		$257.04	$257.04	$257.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $177.83 / $269.15	Professional		$128.82	$177.83	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $154.88 / $257.04	Professional		$97.72	$154.88	$257.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $128.82 / $186.21	Professional		$81.28	$128.82	$186.21