Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $275.42 / $9,772.37	Facility		$28.84	$275.42	$9,772.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $56.23 / $186.21	Professional		$15.14	$56.23	$186.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $117.49 / $186.21	Professional		$15.85	$117.49	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $51.29 / $181.97	Professional		$19.50	$51.29	$181.97
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $61.66 / $199.53	Facility		$23.99	$61.66	$199.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $42.66 / $177.83	Professional		$24.55	$42.66	$177.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $114.82 / $144.54	Facility		$53.70	$114.82	$144.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $61.66 / $177.83	Professional		$21.38	$61.66	$177.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $562.34 / $1,096.48	Facility		$371.54	$562.34	$1,096.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $51.29 / $147.91	Professional		$21.88	$51.29	$147.91
United Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $741.31 / $1,862.09	Facility		$501.19	$741.31	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $54.95 / $165.96	Professional		$20.89	$54.95	$165.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $25.70 / $102.33	Professional		$13.80	$25.70	$102.33