Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $123.03 / $295.12	Facility		$53.70	$123.03	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $38.02 / $117.49	Professional		$25.12	$38.02	$117.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $20.89 / $56.23	Professional		$20.89	$20.89	$56.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $93.33 / $125.89	Facility		$43.65	$93.33	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $43.65 / $56.23	Professional		$23.44	$43.65	$56.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $51.29 / $109.65	Facility		$41.69	$51.29	$109.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $54.95 / $114.82	Professional		$41.69	$54.95	$114.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $44.67 / $75.86	Professional		$36.31	$44.67	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $41.69 / $79.43	Facility		$41.69	$41.69	$79.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $72.44 / $125.89	Facility		$41.69	$72.44	$125.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $37.15 / $50.12	Professional		$37.15	$37.15	$50.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $63.10 / $114.82	Facility		$43.65	$63.10	$114.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $37.15 / $46.77	Professional		$35.48	$37.15	$46.77
United Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $50.12 / $50.12	Facility		$41.69	$50.12	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $20.42 / $50.12	Professional		$17.38	$20.42	$50.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $41.69 / $75.86	Professional		$18.62	$41.69	$75.86