Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $64.57 / $93.33	Professional		$47.86	$64.57	$93.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $83.18 / $141.25	Professional		$79.43	$83.18	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $89.13 / $208.93	Professional		$69.18	$89.13	$208.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $100.00 / $181.97	Facility		$63.10	$100.00	$181.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $104.71 / $186.21	Professional		$63.10	$104.71	$186.21
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 $120.23 / $165.96 / $169.82	Facility		$120.23	$165.96	$169.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $169.82 / $208.93	Professional		$72.44	$169.82	$208.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $70.79 / $83.18	Professional		$60.26	$70.79	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $123.03 / $229.09	Professional		$48.98	$123.03	$229.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $87.10	Professional		$60.26	$60.26	$87.10