Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $1,318.26 / $2,238.72	Facility		$562.34	$1,318.26	$2,238.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $478.63 / $794.33	Professional		$363.08	$478.63	$794.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $660.69	Professional		$660.69	$660.69	$660.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $501.19	Professional		$363.08	$363.08	$501.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $1,202.26 / $2,454.71	Facility		$501.19	$1,202.26	$2,454.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $1,047.13 / $1,862.09	Professional		$501.19	$1,047.13	$1,862.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $588.84 / $724.44	Professional		$75.86	$588.84	$724.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $831.76 / $912.01	Facility		$676.08	$831.76	$912.01
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $851.14 / $912.01	Professional		$776.25	$851.14	$912.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,258.93 / $1,862.09	Facility		$758.58	$1,258.93	$1,862.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $977.24	Professional		$707.95	$707.95	$977.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $831.76	Facility		$831.76	$831.76	$831.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $741.31 / $954.99	Professional		$707.95	$741.31	$954.99
United Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $1,318.26 / $1,318.26	Facility		$524.81	$1,318.26	$1,318.26
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $537.03 / $758.58	Professional		$380.19	$537.03	$758.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $741.31 / $1,318.26	Professional		$616.60	$741.31	$1,318.26