Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Facility		$83.18	$83.18	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $83.18 / $125.89	Professional		$57.54	$83.18	$125.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $109.65	Professional		$30.20	$30.20	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $199.53	Professional		$36.31	$36.31	$199.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $707.95	Professional		$707.95	$707.95	$707.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $70.79	Professional		$44.67	$50.12	$70.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $398.11 / $426.58	Facility		$281.84	$398.11	$426.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $54.95 / $72.44	Professional		$46.77	$54.95	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $128.82 / $331.13	Professional		$125.89	$128.82	$331.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13