Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $120.23 / $154.88	Facility		$72.44	$120.23	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $67.61 / $181.97	Professional		$52.48	$67.61	$181.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $75.86 / $117.49	Professional		$56.23	$75.86	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $79.43 / $162.18	Professional		$47.86	$79.43	$162.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $67.61 / $102.33	Facility		$52.48	$67.61	$102.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $66.07 / $97.72	Professional		$52.48	$66.07	$97.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $42.66 / $64.57	Professional		$32.36	$42.66	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $125.89 / $134.90	Facility		$89.13	$125.89	$134.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $112.20 / $177.83	Professional		$81.28	$112.20	$177.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $354.81 / $549.54	Facility		$354.81	$354.81	$549.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $79.43 / $112.20	Professional		$58.88	$79.43	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $660.69 / $912.01	Facility		$602.56	$660.69	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $85.11 / $162.18	Professional		$56.23	$85.11	$162.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $81.28 / $114.82	Professional		$60.26	$81.28	$114.82