Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $87.10 / $275.42	Facility		$28.18	$87.10	$275.42
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $60.26 / $60.26 / $138.04	Facility	CO	$60.26	$60.26	$138.04
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $63.10 / $100.00 / $407.38	Facility	CQ	$63.10	$100.00	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $50.12 / $177.83	Professional		$18.20	$50.12	$177.83
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $45.71 / $64.57 / $104.71	Professional	CO	$45.71	$64.57	$104.71
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $23.44 / $61.66 / $151.36	Professional	CQ	$23.44	$61.66	$151.36
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $23.99 / $29.51 / $40.74	Professional	CQ	$23.99	$29.51	$40.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $107.15 / $117.49	Facility		$89.13	$107.15	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $31.62 / $72.44	Professional		$20.42	$31.62	$72.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $39.81 / $79.43	Facility		$28.84	$39.81	$79.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $38.90 / $72.44	Professional		$26.92	$38.90	$72.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $32.36 / $33.11	Professional		$19.05	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $58.88 / $61.66	Facility		$44.67	$58.88	$61.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $56.23 / $81.28	Facility		$37.15	$56.23	$81.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $52.48 / $74.13	Professional		$29.51	$52.48	$74.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $43.65 / $83.18	Facility		$36.31	$43.65	$83.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $30.20 / $41.69	Professional		$25.70	$30.20	$41.69
United Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $31.62 / $31.62	Facility		$31.62	$31.62	$31.62
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $31.62 / $72.44	Professional		$26.30	$31.62	$72.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $33.11 / $56.23	Professional		$30.20	$33.11	$56.23