Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $125.89 / $162.18	Facility		$79.43	$125.89	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $112.20 / $194.98	Professional		$57.54	$112.20	$194.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $131.83	Professional		$102.33	$102.33	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $134.90 / $208.93	Professional		$74.13	$134.90	$208.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $134.90 / $173.78	Facility		$67.61	$134.90	$173.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $141.25 / $177.83	Professional		$67.61	$141.25	$177.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $67.61 / $134.90	Professional		$40.74	$67.61	$134.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $138.04 / $141.25	Facility		$114.82	$138.04	$141.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $104.71 / $199.53	Facility		$87.10	$104.71	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $109.65 / $204.17	Professional		$74.13	$109.65	$204.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $81.28 / $134.90	Professional		$70.79	$81.28	$134.90