Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $56.23 / $112.20	Professional		$48.98	$56.23	$112.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Professional		$52.48	$52.48	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $89.13 / $169.82	Professional		$56.23	$89.13	$169.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $72.44 / $131.83	Professional		$47.86	$72.44	$131.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $37.15	Professional		$32.36	$33.11	$37.15
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Professional		$77.62	$77.62	$77.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $112.20 / $162.18	Professional		$77.62	$112.20	$162.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $102.33 / $131.83	Professional		$74.13	$102.33	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $75.86 / $138.04	Professional		$51.29	$75.86	$138.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $70.79 / $117.49	Professional		$61.66	$70.79	$117.49