Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $67.61 / $114.82	Facility		$53.70	$67.61	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $44.67 / $64.57	Professional		$28.18	$44.67	$64.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Professional		$43.65	$43.65	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $66.07 / $117.49	Professional		$39.81	$66.07	$117.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $47.86 / $79.43	Facility		$28.18	$47.86	$79.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $45.71 / $79.43	Professional		$28.18	$45.71	$79.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $60.26	Professional		$32.36	$33.11	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $97.72 / $102.33	Facility		$61.66	$97.72	$102.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $69.18	Facility		$66.07	$66.07	$69.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $75.86 / $128.82	Professional		$41.69	$75.86	$128.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $67.61 / $104.71	Professional		$41.69	$67.61	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $66.07 / $114.82	Professional		$39.81	$66.07	$114.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $61.66 / $107.15	Professional		$56.23	$61.66	$107.15