Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $15.85 / $39.81	Facility		$15.85	$15.85	$39.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $15.14 / $26.92	Professional		$9.12	$15.14	$26.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $14.45 / $14.45	Professional		$14.45	$14.45	$14.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $16.22 / $16.22	Professional		$16.22	$16.22	$16.22
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $44.67 / $53.70	Facility		$26.30	$44.67	$53.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $44.67 / $56.23	Professional		$30.20	$44.67	$56.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $64.57	Professional		$30.20	$50.12	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $38.90 / $39.81	Facility		$27.54	$38.90	$39.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $26.92 / $26.92	Facility		$26.92	$26.92	$26.92
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $38.90 / $57.54	Professional		$26.92	$38.90	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $12.88 / $21.38	Professional		$8.51	$12.88	$21.38