Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $95.50 / $275.42	Facility		$13.18	$95.50	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $12.88 / $46.77	Professional		$12.02	$12.88	$46.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $27.54 / $44.67	Professional		$27.54	$27.54	$44.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $13.18 / $26.30	Facility		$13.18	$13.18	$26.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $13.18 / $13.18	Professional		$13.18	$13.18	$13.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $46.77 / $87.10	Facility		$19.05	$46.77	$87.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $46.77 / $85.11	Professional		$23.99	$46.77	$85.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $33.11 / $75.86	Professional		$16.22	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $14.79 / $14.79 / $83.18	Facility		$14.79	$14.79	$83.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $14.79 / $14.79 / $14.79	Facility		$14.79	$14.79	$14.79
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $14.79 / $14.79	Professional		$14.79	$14.79	$14.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14.79 / $14.79 / $14.79	Facility		$14.79	$14.79	$14.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $14.79 / $14.79	Professional		$14.79	$14.79	$14.79
United Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $12.88 / $15.49	Professional		$12.88	$12.88	$15.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $19.05 / $20.89	Professional		$14.79	$19.05	$20.89