Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $102.33 / $213.80	Facility		$79.43	$102.33	$213.80
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $93.33 / $93.33 / $93.33	Facility	25	$93.33	$93.33	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $85.11 / $245.47	Professional		$58.88	$85.11	$245.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $123.03 / $158.49	Professional		$81.28	$123.03	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $141.25 / $239.88	Professional		$75.86	$141.25	$239.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $134.90 / $190.55	Facility		$64.57	$134.90	$190.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $154.88 / $194.98	Professional		$67.61	$154.88	$194.98
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 $109.65 / $138.04 / $162.18	Facility		$109.65	$138.04	$162.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $104.71	Facility		$93.33	$93.33	$104.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $173.78 / $234.42	Professional		$104.71	$173.78	$234.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $141.25 / $213.80	Professional		$95.50	$141.25	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $104.71 / $208.93	Professional		$74.13	$104.71	$208.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $87.10 / $144.54	Professional		$21.38	$87.10	$144.54