Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $165.96 / $269.15	Facility		$112.20	$165.96	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $123.03 / $346.74	Professional		$81.28	$123.03	$346.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $181.97 / $213.80	Professional		$102.33	$181.97	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $204.17 / $346.74	Professional		$107.15	$204.17	$346.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $204.17 / $275.42	Facility		$93.33	$204.17	$275.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $218.78 / $281.84	Professional		$95.50	$218.78	$281.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $199.53 / $234.42	Facility		$144.54	$199.53	$234.42
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $151.36	Facility		$134.90	$134.90	$151.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $257.04 / $338.84	Professional		$151.36	$257.04	$338.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $204.17 / $309.03	Professional		$134.90	$204.17	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $151.36 / $302.00	Professional		$107.15	$151.36	$302.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $123.03 / $204.17	Professional		$30.90	$123.03	$204.17