Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $302.00 / $426.58	Facility		$181.97	$302.00	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $173.78 / $354.81	Professional		$128.82	$173.78	$354.81
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $229.09 / $229.09 / $229.09	Professional	25	$229.09	$229.09	$229.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $158.49 / $223.87	Professional		$141.25	$158.49	$223.87
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $239.88 / $239.88 / $257.04	Professional	25	$239.88	$239.88	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $208.93 / $398.11	Professional		$147.91	$208.93	$398.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Facility		$371.54	$371.54	$371.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Professional		$371.54	$371.54	$371.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $316.23 / $363.08	Facility		$239.88	$316.23	$363.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $234.42	Facility		$213.80	$213.80	$234.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $380.19 / $524.81	Professional		$234.42	$380.19	$524.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $354.81 / $478.63	Professional		$218.78	$354.81	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $223.87 / $467.74	Professional		$177.83	$223.87	$467.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $234.42 / $371.54	Professional		$190.55	$234.42	$371.54