Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $107.15 / $489.78	Professional		$63.10	$107.15	$489.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $120.23 / $134.90	Professional		$54.95	$120.23	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $87.10 / $125.89	Professional		$43.65	$87.10	$125.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $158.49 / $245.47	Facility		$97.72	$158.49	$245.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $186.21 / $251.19	Professional		$104.71	$186.21	$251.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $186.21 / $194.98	Facility		$134.90	$186.21	$194.98
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $190.55 / $251.19	Professional		$125.89	$190.55	$251.19
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 $83.18 / $83.18 / $83.18	Facility		$83.18	$83.18	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $83.18 / $186.21	Professional		$50.12	$83.18	$186.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50