Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $251.19 / $354.81	Facility		$251.19	$251.19	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $177.83 / $512.86	Professional		$114.82	$177.83	$512.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $186.21 / $371.54	Professional		$109.65	$186.21	$371.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Facility		$218.78	$218.78	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $229.09 / $416.87	Professional		$144.54	$229.09	$416.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $223.87 / $575.44	Facility		$134.90	$223.87	$575.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $208.93 / $338.84	Professional		$128.82	$208.93	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $109.65	Professional		$32.36	$33.11	$109.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $275.42 / $288.40	Facility		$229.09	$275.42	$288.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $295.12 / $389.05	Professional		$181.97	$295.12	$389.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $263.03 / $354.81	Professional		$194.98	$263.03	$354.81
United Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,454.71 / $3,388.44	Facility		$2,238.72	$2,454.71	$3,388.44
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $204.17 / $338.84	Professional		$138.04	$204.17	$338.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $131.83 / $234.42	Professional		$125.89	$131.83	$234.42