Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $72.44 / $181.97	Professional		$39.81	$72.44	$181.97
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $21.88 / $102.33 / $416.87	Professional	25	$21.88	$102.33	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $173.78	Professional		$138.04	$138.04	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $93.33 / $190.55	Professional		$47.86	$93.33	$190.55
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $104.71 / $218.78	Facility		$60.26	$104.71	$218.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $104.71 / $204.17	Professional		$60.26	$104.71	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.11 / $54.95	Professional		$28.84	$33.11	$54.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $154.88 / $169.82	Facility		$107.15	$154.88	$169.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $125.89 / $218.78	Professional		$77.62	$125.89	$218.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $61.66 / $109.65	Professional		$48.98	$61.66	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $89.13 / $162.18	Professional		$51.29	$89.13	$162.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $69.18 / $128.82	Professional		$44.67	$69.18	$128.82