Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $112.20 / $154.88	Facility		$83.18	$112.20	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $61.66 / $87.10	Professional		$46.77	$61.66	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $102.33 / $169.82	Professional		$56.23	$102.33	$169.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $67.61 / $102.33	Facility		$52.48	$67.61	$102.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $67.61 / $100.00	Professional		$53.70	$67.61	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $51.29 / $91.20	Professional		$38.02	$51.29	$91.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $128.82 / $131.83	Facility		$97.72	$128.82	$131.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $117.49 / $181.97	Professional		$93.33	$117.49	$181.97
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $109.65 / $154.88	Professional		$83.18	$109.65	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $87.10 / $165.96	Professional		$57.54	$87.10	$165.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $74.13 / $107.15	Professional		$56.23	$74.13	$107.15