Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $107.15 / $134.90	Facility		$67.61	$107.15	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $50.12 / $74.13	Professional		$40.74	$50.12	$74.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $51.29	Professional		$51.29	$51.29	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $93.33 / $147.91	Professional		$63.10	$93.33	$147.91
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $66.07 / $109.65	Facility		$46.77	$66.07	$109.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $64.57 / $102.33	Professional		$46.77	$64.57	$102.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $57.54	Professional		$32.36	$33.11	$57.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $117.49 / $120.23	Facility		$77.62	$117.49	$120.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $79.43 / $79.43	Facility		$77.62	$79.43	$79.43
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $109.65 / $147.91	Professional		$66.07	$109.65	$147.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $89.13 / $128.82	Professional		$69.18	$89.13	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $89.13 / $151.36	Professional		$63.10	$89.13	$151.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $64.57 / $91.20	Professional		$43.65	$64.57	$91.20