Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $407.38 / $831.76	Facility		$407.38	$407.38	$831.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $323.59 / $407.38	Professional		$245.47	$323.59	$407.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $338.84 / $346.74	Professional		$281.84	$338.84	$346.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $588.84 / $588.84	Facility		$588.84	$588.84	$588.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $426.58	Professional		$380.19	$380.19	$426.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $407.38 / $812.83	Facility		$263.03	$407.38	$812.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $398.11 / $776.25	Professional		$257.04	$398.11	$776.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $776.25 / $851.14	Facility		$562.34	$776.25	$851.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $630.96 / $1,096.48	Professional		$489.78	$630.96	$1,096.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $537.03 / $537.03	Facility		$537.03	$537.03	$537.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $549.54 / $912.01	Professional		$380.19	$549.54	$912.01
United Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $676.08 / $912.01	Facility		$602.56	$676.08	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $478.63 / $776.25	Professional		$309.03	$478.63	$776.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $489.78 / $851.14	Professional		$446.68	$489.78	$851.14