Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $851.14 / $2,884.03	Facility		$346.74	$851.14	$2,884.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $309.03 / $489.78	Professional		$234.42	$309.03	$489.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $512.86 / $512.86	Professional		$512.86	$512.86	$512.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $363.08 / $363.08	Facility		$363.08	$363.08	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $363.08	Professional		$263.03	$263.03	$363.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $758.58 / $1,445.44	Facility		$323.59	$758.58	$1,445.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $645.65 / $1,174.90	Professional		$323.59	$645.65	$1,174.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $389.05 / $426.58	Professional		$75.86	$389.05	$426.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $501.19 / $512.86	Facility		$407.38	$501.19	$512.86
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $512.86 / $512.86	Professional		$457.09	$512.86	$512.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $741.31 / $1,096.48	Facility		$446.68	$741.31	$1,096.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $588.84	Professional		$426.58	$426.58	$588.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $446.68 / $575.44	Professional		$416.87	$446.68	$575.44
United Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $831.76 / $831.76	Facility		$251.19	$831.76	$831.76
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $275.42 / $489.78	Professional		$239.88	$275.42	$489.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $446.68 / $776.25	Professional		$363.08	$446.68	$776.25