Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $45.71 / $63.10	Facility		$38.90	$45.71	$63.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $23.99 / $50.12	Professional		$19.95	$23.99	$50.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Professional		$50.12	$50.12	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $30.20 / $60.26	Professional		$18.62	$30.20	$60.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $25.70 / $37.15	Facility		$19.95	$25.70	$37.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $25.70 / $37.15	Professional		$19.95	$25.70	$37.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $32.36 / $37.15	Professional		$19.95	$32.36	$37.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $47.86 / $51.29	Facility		$33.11	$47.86	$51.29
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $33.11 / $33.11	Facility		$33.11	$33.11	$33.11
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $42.66 / $67.61	Professional		$30.20	$42.66	$67.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $29.51 / $41.69	Professional		$22.39	$29.51	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $32.36 / $61.66	Professional		$21.38	$32.36	$61.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $30.90 / $54.95	Professional		$28.84	$30.90	$54.95