Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $331.13 / $331.13	Facility		$331.13	$331.13	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $181.97 / $257.04	Professional		$128.82	$181.97	$257.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $165.96	Professional		$162.18	$162.18	$165.96
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	25	$138.04	$138.04	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $223.87 / $380.19	Professional		$158.49	$223.87	$380.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $138.04	Professional		$32.36	$33.11	$138.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $338.84 / $371.54	Facility		$251.19	$338.84	$371.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $239.88	Facility		$234.42	$234.42	$239.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $346.74 / $457.09	Professional		$234.42	$346.74	$457.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Professional		$467.74	$467.74	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $295.12 / $501.19	Professional		$223.87	$295.12	$501.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $194.98 / $371.54	Professional		$177.83	$194.98	$371.54