Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $851.14 / $1,621.81	Facility		$251.19	$851.14	$1,621.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $302.00 / $851.14	Professional		$177.83	$302.00	$851.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $251.19 / $275.42	Professional		$245.47	$251.19	$275.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $208.93	Professional		$154.88	$154.88	$208.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $501.19 / $1,047.13	Facility		$213.80	$501.19	$1,047.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $436.52 / $776.25	Professional		$204.17	$436.52	$776.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $281.84 / $309.03	Professional		$75.86	$281.84	$309.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $363.08 / $380.19	Facility		$295.12	$363.08	$380.19
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $371.54 / $380.19	Professional		$331.13	$371.54	$380.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $537.03 / $794.33	Facility		$323.59	$537.03	$794.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $407.38	Professional		$309.03	$309.03	$407.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $363.08 / $363.08	Facility		$363.08	$363.08	$363.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $323.59 / $416.87	Professional		$302.00	$323.59	$416.87
United Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $549.54 / $549.54	Facility		$165.96	$549.54	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $181.97 / $323.59	Professional		$154.88	$181.97	$323.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $323.59 / $562.34	Professional		$263.03	$323.59	$562.34