Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $42.66 / $77.62	Facility		$30.90	$42.66	$77.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $30.20 / $64.57	Professional		$21.88	$30.20	$64.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $43.65 / $79.43	Professional		$26.30	$43.65	$79.43
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $30.90 / $48.98	Facility		$21.88	$30.90	$48.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $30.20 / $48.98	Professional		$21.88	$30.20	$48.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $32.36 / $33.11	Professional		$15.14	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $63.10 / $64.57	Facility		$42.66	$63.10	$64.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $42.66	Facility		$42.66	$42.66	$42.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $81.28	Professional		$32.36	$50.12	$81.28
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $46.77 / $67.61	Professional		$33.11	$46.77	$67.61
United Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $20.89 / $22.91	Facility		$16.98	$20.89	$22.91
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $44.67 / $83.18	Professional		$28.84	$44.67	$83.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $37.15 / $63.10	Professional		$33.88	$37.15	$63.10