Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $616.60 / $933.25	Facility		$51.29	$616.60	$933.25
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $346.74 / $794.33 / $1,548.82	Facility	25	$346.74	$794.33	$1,548.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $53.70 / $128.82	Professional		$30.90	$53.70	$128.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $70.79 / $151.36	Professional		$39.81	$70.79	$151.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Facility		$891.25	$891.25	$891.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $72.44 / $134.90	Professional		$42.66	$72.44	$134.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $70.79 / $407.38	Facility		$36.31	$70.79	$407.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $56.23 / $95.50	Professional		$35.48	$56.23	$95.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $35.48	Professional		$32.36	$33.11	$35.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $77.62 / $83.18	Facility		$57.54	$77.62	$83.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $87.10 / $120.23	Professional		$58.88	$87.10	$120.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $77.62 / $109.65	Professional		$56.23	$77.62	$109.65
United Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $776.25	Facility		$724.44	$724.44	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $61.66 / $114.82	Professional		$42.66	$61.66	$114.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $42.66 / $75.86	Professional		$39.81	$42.66	$75.86