Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $4,570.88 / $13,489.63	Facility		$660.69	$4,570.88	$13,489.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $630.96 / $9,549.93	Professional		$588.84	$630.96	$9,549.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $562.34 / $724.44	Professional		$562.34	$562.34	$724.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $912.01 / $1,380.38	Facility		$645.65	$912.01	$1,380.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Professional		$645.65	$645.65	$645.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $1,737.80 / $2,754.23	Facility		$562.34	$1,737.80	$2,754.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Professional		$724.44	$724.44	$724.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $60.26	Professional		$30.20	$30.20	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $524.81	Facility		$524.81	$524.81	$524.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $660.69 / $1,348.96	Facility		$331.13	$660.69	$1,348.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $707.95	Professional		$707.95	$707.95	$707.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $741.31 / $1,778.28	Facility		$616.60	$741.31	$1,778.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $707.95 / $707.95	Professional		$537.03	$707.95	$707.95
United Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Facility		$346.74	$346.74	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Professional		$630.96	$630.96	$630.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $1,023.29	Professional		$707.95	$707.95	$1,023.29