Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $97.72 / $134.90	Facility		$34.67	$97.72	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $48.98 / $95.50	Professional		$30.90	$48.98	$95.50
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $42.66 / $54.95 / $67.61	Professional	25	$42.66	$54.95	$67.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $70.79 / $114.82	Professional		$53.70	$70.79	$114.82
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $63.10 / $63.10 / $63.10	Professional	25	$63.10	$63.10	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $77.62 / $144.54	Professional		$38.90	$77.62	$144.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $47.86 / $120.23	Facility		$33.11	$47.86	$120.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $46.77 / $97.72	Professional		$30.20	$46.77	$97.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $102.33 / $125.89	Facility		$66.07	$102.33	$125.89
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $83.18 / $83.18	Facility		$81.28	$83.18	$83.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $107.15 / $154.88	Professional		$64.57	$107.15	$154.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $251.19 / $478.63	Facility		$162.18	$251.19	$478.63
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $87.10 / $131.83	Professional		$66.07	$87.10	$131.83
United Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $380.19 / $691.83	Facility		$288.40	$380.19	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $61.66 / $141.25	Professional		$40.74	$61.66	$141.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $67.61 / $95.50	Professional		$43.65	$67.61	$95.50