Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $128.82 / $331.13	Facility		$56.23	$128.82	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $54.95 / $81.28	Professional		$52.48	$54.95	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $81.28	Professional		$38.90	$38.90	$81.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $56.23 / $112.20	Facility		$56.23	$56.23	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $56.23	Professional		$56.23	$56.23	$56.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $134.90 / $173.78	Facility		$72.44	$134.90	$173.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $134.90 / $177.83	Professional		$91.20	$134.90	$177.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Facility		$63.10	$63.10	$63.10
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Professional		$63.10	$63.10	$63.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Facility		$63.10	$63.10	$63.10
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Professional		$63.10	$63.10	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $67.61	Professional		$56.23	$56.23	$67.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $81.28 / $89.13	Professional		$63.10	$81.28	$89.13