Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $218.78 / $316.23	Facility		$131.83	$218.78	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $162.18 / $407.38	Professional		$91.20	$162.18	$407.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $138.04 / $269.15	Professional		$112.20	$138.04	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $169.82 / $323.59	Professional		$100.00	$169.82	$323.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $141.25 / $275.42	Facility		$87.10	$141.25	$275.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $141.25 / $263.03	Professional		$87.10	$141.25	$263.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $64.57	Professional		$32.36	$50.12	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $257.04 / $269.15	Facility		$186.21	$257.04	$269.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Facility		$177.83	$177.83	$177.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $204.17 / $331.13	Professional		$141.25	$204.17	$331.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Facility		$281.84	$281.84	$281.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $186.21 / $288.40	Professional		$134.90	$186.21	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $165.96 / $275.42	Professional		$102.33	$165.96	$275.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $138.04 / $199.53	Professional		$85.11	$138.04	$199.53