Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $138.04 / $660.69	Facility		$17.38	$138.04	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $21.88 / $128.82	Professional		$11.22	$21.88	$128.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $20.42 / $44.67	Professional		$14.13	$20.42	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $45.71 / $123.03	Professional		$14.79	$45.71	$123.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $14.45 / $45.71 / $114.82	Facility		$14.45	$45.71	$114.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $40.74 / $112.20	Professional		$13.49	$40.74	$112.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $32.36 / $33.11	Professional		$9.33	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $97.72 / $102.33	Facility		$69.18	$97.72	$102.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $48.98 / $125.89	Professional		$16.60	$48.98	$125.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $45.71 / $104.71	Professional		$15.49	$45.71	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $44.67 / $112.20	Professional		$15.85	$44.67	$112.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $61.66 / $102.33	Professional		$44.67	$61.66	$102.33