Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $89.13 / $436.52	Facility		$35.48	$89.13	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $30.20 / $85.11	Professional		$22.91	$30.20	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $31.62 / $31.62	Professional		$31.62	$31.62	$31.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $309.03 / $371.54	Facility		$165.96	$309.03	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $44.67 / $87.10	Professional		$25.12	$44.67	$87.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $54.95 / $165.96	Facility		$30.20	$54.95	$165.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $50.12 / $75.86	Professional		$25.70	$50.12	$75.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $32.36 / $33.11	Professional		$13.80	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $53.70 / $58.88	Facility		$42.66	$53.70	$58.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $39.81 / $40.74	Facility		$39.81	$39.81	$40.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $64.57 / $85.11	Professional		$40.74	$64.57	$85.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $251.19 / $489.78	Facility		$158.49	$251.19	$489.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $60.26 / $83.18	Professional		$40.74	$60.26	$83.18
United Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $331.13 / $588.84	Facility		$245.47	$331.13	$588.84
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $32.36 / $75.86	Professional		$26.30	$32.36	$75.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $34.67 / $56.23	Professional		$29.51	$34.67	$56.23