Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $77.62 / $194.98	Facility		$34.67	$77.62	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $28.18 / $57.54	Professional		$18.62	$28.18	$57.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $14.79 / $29.51	Professional		$14.79	$14.79	$29.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $77.62 / $112.20	Facility		$36.31	$77.62	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $38.90 / $51.29	Professional		$21.88	$38.90	$51.29
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $50.12 / $100.00	Facility		$35.48	$50.12	$100.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $51.29 / $107.15	Professional		$35.48	$51.29	$107.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.88 / $75.86	Professional		$28.18	$33.88	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $67.61	Facility		$35.48	$35.48	$67.61
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $61.66 / $104.71	Facility		$35.48	$61.66	$104.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $31.62 / $41.69	Professional		$31.62	$31.62	$41.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $52.48 / $95.50	Facility		$37.15	$52.48	$95.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $31.62 / $40.74	Professional		$29.51	$31.62	$40.74
United Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $41.69 / $41.69	Facility		$35.48	$41.69	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $20.42 / $41.69	Professional		$14.79	$20.42	$41.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $35.48 / $63.10	Professional		$15.85	$35.48	$63.10