Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $27.54 / $37.15	Facility		$20.42	$27.54	$37.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $14.13 / $33.11	Professional		$10.00	$14.13	$33.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $13.49 / $151.36	Professional		$11.48	$13.49	$151.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $19.05 / $19.05	Facility		$19.05	$19.05	$19.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $20.42 / $38.90	Professional		$13.18	$20.42	$38.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $10.96 / $16.98 / $28.18	Facility		$10.96	$16.98	$28.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $16.22 / $26.92	Professional		$10.96	$16.22	$26.92
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 $19.05 / $25.70 / $26.92	Facility		$19.05	$25.70	$26.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $24.55 / $43.65	Facility		$20.89	$24.55	$43.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $21.88 / $35.48	Professional		$15.49	$21.88	$35.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $28.84 / $28.84	Facility		$28.84	$28.84	$28.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $21.38 / $30.20	Professional		$14.79	$21.38	$30.20
United Facility/Professional Facility Modifier Low / Median / High Price $8.32 / $11.48 / $11.48	Facility		$8.32	$11.48	$11.48
United Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $18.62 / $30.20	Professional		$12.30	$18.62	$30.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3.80 / $15.14 / $26.30	Professional		$3.80	$15.14	$26.30