Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $138.04 / $177.83	Facility		$114.82	$138.04	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $74.13 / $165.96	Professional		$52.48	$74.13	$165.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $66.07 / $120.23	Professional		$54.95	$66.07	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $79.43 / $173.78	Professional		$33.88	$79.43	$173.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $53.70 / $95.50	Facility		$38.02	$53.70	$95.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $58.88 / $97.72	Professional		$38.02	$58.88	$97.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $46.77 / $63.10	Professional		$32.36	$46.77	$63.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $125.89 / $144.54	Facility		$91.20	$125.89	$144.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Facility		$93.33	$93.33	$93.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $123.03 / $190.55	Professional		$75.86	$123.03	$190.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $85.11 / $128.82	Professional		$66.07	$85.11	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $89.13 / $177.83	Professional		$56.23	$89.13	$177.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $89.13 / $125.89	Professional		$66.07	$89.13	$125.89