Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $37.15 / $72.44	Professional		$28.84	$37.15	$72.44
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $97.72 / $97.72 / $97.72	Professional	22	$97.72	$97.72	$97.72
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $33.88 / $39.81 / $56.23	Professional	52	$33.88	$39.81	$56.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $57.54 / $74.13	Professional		$33.88	$57.54	$74.13
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $16.98 / $16.98 / $19.05	Professional	52	$16.98	$16.98	$19.05
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 $31.62 / $51.29 / $102.33	Professional		$31.62	$51.29	$102.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $47.86 / $89.13	Facility		$33.11	$47.86	$89.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $47.86 / $79.43	Professional		$33.11	$47.86	$79.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $32.36 / $33.11	Professional		$20.42	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $72.44 / $77.62	Facility		$56.23	$72.44	$77.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Facility		$50.12	$50.12	$50.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $77.62 / $102.33	Professional		$50.12	$77.62	$102.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $38.02 / $70.79	Professional		$32.36	$38.02	$70.79
United Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $660.69	Facility		$660.69	$660.69	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $53.70 / $91.20	Professional		$36.31	$53.70	$91.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $42.66 / $51.29	Professional		$36.31	$42.66	$51.29