Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $33.11 / $51.29	Professional		$23.99	$33.11	$51.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $52.48 / $87.10	Professional		$43.65	$52.48	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $47.86 / $104.71	Professional		$33.88	$47.86	$104.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $54.95 / $109.65	Facility		$31.62	$54.95	$109.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $54.95 / $95.50	Professional		$31.62	$54.95	$95.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $87.10 / $91.20	Facility		$63.10	$87.10	$91.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $85.11 / $112.20	Professional		$38.90	$85.11	$112.20
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $37.15 / $44.67	Professional		$30.20	$37.15	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $63.10 / $117.49	Professional		$36.31	$63.10	$117.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $46.77	Professional		$46.77	$46.77	$46.77