Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $512.86 / $17,782.79	Facility		$47.86	$512.86	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $77.62 / $446.68	Professional		$22.91	$77.62	$446.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $66.07 / $120.23	Professional		$35.48	$66.07	$120.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $1,122.02	Facility		$645.65	$645.65	$1,122.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $61.66 / $131.83	Professional		$27.54	$61.66	$131.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $63.10 / $128.82	Facility		$34.67	$63.10	$128.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $63.10 / $128.82	Professional		$34.67	$63.10	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $97.72 / $102.33	Facility		$48.98	$97.72	$102.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $66.07 / $125.89	Professional		$29.51	$66.07	$125.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $58.88 / $104.71	Professional		$29.51	$58.88	$104.71
United Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $645.65 / $5,754.40	Facility		$141.25	$645.65	$5,754.40
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $61.66 / $125.89	Professional		$29.51	$61.66	$125.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $57.54 / $95.50	Professional		$50.12	$57.54	$95.50