Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $891.25 / $1,819.70	Facility		$467.74	$891.25	$1,819.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $398.11 / $660.69	Professional		$302.00	$398.11	$660.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $537.03 / $588.84	Professional		$537.03	$537.03	$588.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $436.52	Facility		$436.52	$436.52	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $436.52	Professional		$323.59	$323.59	$436.52
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $1,000.00 / $2,041.74	Facility		$416.87	$1,000.00	$2,041.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $870.96 / $1,548.82	Professional		$416.87	$870.96	$1,548.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $489.78 / $602.56	Professional		$75.86	$489.78	$602.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $691.83 / $758.58	Facility		$562.34	$691.83	$758.58
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $724.44 / $758.58	Professional		$645.65	$724.44	$758.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,047.13 / $1,548.82	Facility		$630.96	$1,047.13	$1,548.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $588.84 / $812.83	Professional		$588.84	$588.84	$812.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Facility		$691.83	$691.83	$691.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $616.60 / $812.83	Professional		$588.84	$616.60	$812.83
United Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $1,096.48 / $1,096.48	Facility		$436.52	$1,096.48	$1,096.48
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $446.68 / $630.96	Professional		$316.23	$446.68	$630.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $616.60 / $1,096.48	Professional		$512.86	$616.60	$1,096.48