Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $194.98 / $257.04	Facility		$165.96	$194.98	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $109.65 / $275.42	Professional		$83.18	$109.65	$275.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $102.33 / $125.89	Professional		$87.10	$102.33	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Facility		$147.91	$147.91	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $151.36 / $269.15	Professional		$97.72	$151.36	$269.15
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $134.90 / $234.42	Facility		$87.10	$134.90	$234.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $128.82 / $223.87	Professional		$85.11	$128.82	$223.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $44.67 / $60.26	Professional		$32.36	$44.67	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $208.93 / $218.78	Facility		$154.88	$208.93	$218.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $181.97 / $288.40	Professional		$138.04	$181.97	$288.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $173.78 / $251.19	Professional		$128.82	$173.78	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $151.36 / $239.88	Professional		$100.00	$151.36	$239.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $114.82 / $162.18	Professional		$83.18	$114.82	$162.18