Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $79.43 / $398.11	Professional		$38.02	$79.43	$398.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Professional		$104.71	$104.71	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $61.66 / $93.33	Professional		$37.15	$61.66	$93.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $141.25 / $186.21	Facility		$77.62	$141.25	$186.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $141.25 / $186.21	Professional		$97.72	$141.25	$186.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $38.02	Professional		$32.36	$33.11	$38.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $120.23 / $162.18	Facility		$100.00	$120.23	$162.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $141.25 / $165.96	Professional		$85.11	$141.25	$165.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $114.82 / $154.88	Professional		$83.18	$114.82	$154.88
United Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $58.88 / $134.90	Professional		$37.15	$58.88	$134.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88