Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $93.33 / $380.19	Facility		$45.71	$93.33	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $42.66 / $100.00	Professional		$33.88	$42.66	$100.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Professional		$74.13	$74.13	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $64.57 / $123.03	Professional		$35.48	$64.57	$123.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $77.62 / $104.71	Facility		$50.12	$77.62	$104.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $75.86 / $107.15	Professional		$43.65	$75.86	$107.15
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 $56.23 / $79.43 / $81.28	Facility		$56.23	$79.43	$81.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $89.13 / $117.49	Professional		$54.95	$89.13	$117.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $85.11 / $112.20	Professional		$54.95	$85.11	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $43.65 / $104.71	Professional		$31.62	$43.65	$104.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $47.86 / $77.62	Professional		$41.69	$47.86	$77.62