Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $54.95 / $81.28	Professional		$40.74	$54.95	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $120.23 / $165.96	Professional		$70.79	$120.23	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $75.86 / $173.78	Professional		$57.54	$75.86	$173.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $87.10 / $151.36	Facility		$52.48	$87.10	$151.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $87.10 / $154.88	Professional		$52.48	$87.10	$154.88
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 $95.50 / $138.04 / $144.54	Facility		$95.50	$138.04	$144.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $144.54 / $177.83	Professional		$61.66	$144.54	$177.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $58.88 / $70.79	Professional		$50.12	$58.88	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $102.33 / $190.55	Professional		$42.66	$102.33	$190.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $75.86	Professional		$50.12	$50.12	$75.86