Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $81.28 / $309.03	Professional		$52.48	$81.28	$309.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $134.90 / $218.78	Professional		$39.81	$134.90	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $83.18 / $120.23	Professional		$45.71	$83.18	$120.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $186.21 / $245.47	Facility		$104.71	$186.21	$245.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $186.21 / $245.47	Professional		$131.83	$186.21	$245.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $52.48	Professional		$32.36	$33.11	$52.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $162.18 / $204.17	Facility		$134.90	$162.18	$204.17
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $181.97 / $223.87	Professional		$114.82	$181.97	$223.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $154.88 / $204.17	Professional		$112.20	$154.88	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $79.43 / $181.97	Professional		$50.12	$79.43	$181.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Professional		$81.28	$81.28	$81.28