Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $72.44 / $138.04	Facility		$47.86	$72.44	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $51.29 / $112.20	Professional		$25.12	$51.29	$112.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Professional		$64.57	$64.57	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $70.79 / $162.18	Professional		$40.74	$70.79	$162.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $67.61 / $158.49	Facility		$40.74	$67.61	$158.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $66.07 / $141.25	Professional		$41.69	$66.07	$141.25
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 $66.07 / $100.00 / $117.49	Facility		$66.07	$100.00	$117.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $81.28	Facility		$79.43	$79.43	$81.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $75.86 / $151.36	Professional		$36.31	$75.86	$151.36
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $181.97 / $338.84	Facility		$131.83	$181.97	$338.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $70.79 / $138.04	Professional		$39.81	$70.79	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $229.09 / $1,862.09	Facility		$169.82	$229.09	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $67.61 / $141.25	Professional		$36.31	$67.61	$141.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $42.66 / $77.62	Professional		$22.39	$42.66	$77.62