Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $58.88 / $177.83	Professional		$26.92	$58.88	$177.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $30.90 / $36.31	Professional		$23.99	$30.90	$36.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $39.81 / $69.18	Professional		$19.05	$39.81	$69.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $87.10 / $151.36	Facility		$50.12	$87.10	$151.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $87.10 / $144.54	Professional		$50.12	$87.10	$144.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $35.48	Professional		$32.36	$32.36	$35.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $102.33 / $109.65	Facility		$70.79	$102.33	$109.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $87.10 / $144.54	Professional		$56.23	$87.10	$144.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $77.62 / $120.23	Professional		$47.86	$77.62	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $42.66	Facility		$42.66	$42.66	$42.66
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $34.67 / $87.10	Professional		$22.91	$34.67	$87.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Professional		$53.70	$53.70	$53.70