Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $11.75 / $30.90 / $199.53	Facility		$11.75	$30.90	$199.53
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $63.10 / $147.91 / $457.09	Facility	25	$63.10	$147.91	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.59 / $22.91 / $58.88	Professional		$7.59	$22.91	$58.88
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $19.05 / $34.67 / $79.43	Professional	25	$19.05	$34.67	$79.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $25.12 / $46.77	Professional		$13.80	$25.12	$46.77
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $18.62 / $23.44 / $50.12	Professional	25	$18.62	$23.44	$50.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $85.11 / $147.91	Facility		$27.54	$85.11	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $22.91 / $47.86	Professional		$10.23	$22.91	$47.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $8.32 / $18.62 / $42.66	Facility		$8.32	$18.62	$42.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $18.20 / $39.81	Professional		$8.13	$18.20	$39.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $32.36 / $33.11	Professional		$8.51	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $38.90 / $46.77	Facility		$27.54	$38.90	$46.77
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $30.90 / $30.90	Facility		$30.90	$30.90	$30.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $30.20 / $57.54	Professional		$11.22	$30.20	$57.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $26.30 / $47.86	Professional		$12.02	$26.30	$47.86
United Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $21.88 / $43.65	Professional		$9.77	$21.88	$43.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $28.84 / $35.48	Professional		$8.91	$28.84	$35.48