Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $147.91 / $181.97	Facility		$91.20	$147.91	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $75.86 / $112.20	Professional		$61.66	$75.86	$112.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Professional		$165.96	$165.96	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $204.17	Professional		$91.20	$131.83	$204.17
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $89.13 / $158.49	Facility		$67.61	$89.13	$158.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $89.13 / $144.54	Professional		$67.61	$89.13	$144.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $162.18 / $165.96	Facility		$109.65	$162.18	$165.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $123.03	Facility		$109.65	$109.65	$123.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $151.36 / $218.78	Professional		$109.65	$151.36	$218.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $125.89 / $186.21	Professional		$97.72	$125.89	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $123.03 / $213.80	Professional		$87.10	$123.03	$213.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $89.13 / $125.89	Professional		$64.57	$89.13	$125.89