Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $75.86 / $295.12	Facility		$51.29	$75.86	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $36.31 / $141.25	Professional		$26.92	$36.31	$141.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $51.29 / $56.23	Professional		$26.30	$51.29	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $51.29 / $97.72	Professional		$32.36	$51.29	$97.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $40.74 / $66.07	Facility		$30.90	$40.74	$66.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $40.74 / $66.07	Professional		$29.51	$40.74	$66.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $32.36 / $33.11	Professional		$18.20	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $57.54 / $64.57	Facility		$47.86	$57.54	$64.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Facility		$39.81	$39.81	$39.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $58.88 / $85.11	Professional		$39.81	$58.88	$85.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $56.23 / $77.62	Professional		$40.74	$56.23	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $50.12 / $85.11	Professional		$33.88	$50.12	$85.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $32.36 / $56.23	Professional		$29.51	$32.36	$56.23