Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $165.96 / $812.83	Facility		$53.70	$165.96	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $42.66 / $93.33	Professional		$19.95	$42.66	$93.33
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $95.50 / $95.50 / $95.50	Professional	25	$95.50	$95.50	$95.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $23.44 / $33.11	Professional		$20.42	$23.44	$33.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $37.15 / $37.15	Facility		$37.15	$37.15	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $36.31 / $74.13	Professional		$20.89	$36.31	$74.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $30.20 / $64.57	Facility		$22.91	$30.20	$64.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $28.84 / $54.95	Professional		$21.88	$28.84	$54.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $22.91 / $33.11	Professional		$16.60	$22.91	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $50.12 / $56.23	Facility		$37.15	$50.12	$56.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $35.48	Facility		$35.48	$35.48	$35.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $46.77 / $72.44	Professional		$28.18	$46.77	$72.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $33.88 / $302.00	Facility		$26.30	$33.88	$302.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $31.62 / $42.66	Professional		$23.99	$31.62	$42.66
United Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $371.54 / $512.86	Facility		$346.74	$371.54	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $39.81 / $69.18	Professional		$27.54	$39.81	$69.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $33.11 / $58.88	Professional		$30.90	$33.11	$58.88