Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $19.95 / $131.83	Professional		$16.60	$19.95	$131.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $40.74 / $50.12	Professional		$38.02	$40.74	$50.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $24.55 / $32.36	Facility		$24.55	$24.55	$32.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $24.55 / $32.36	Professional		$20.42	$24.55	$32.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $61.66	Facility		$36.31	$36.31	$61.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $61.66	Professional		$36.31	$36.31	$61.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $46.77 / $51.29	Professional		$41.69	$46.77	$51.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $58.88	Facility		$35.48	$35.48	$58.88
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $50.12	Professional		$35.48	$35.48	$50.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2.88 / $3.63 / $36.31	Facility		$2.88	$3.63	$36.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2.88 / $4.37 / $33.88	Professional		$2.88	$4.37	$33.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4.07 / $5.01 / $5.01	Professional		$4.07	$5.01	$5.01
United Facility/Professional Facility Modifier Low / Median / High Price $2.00 / $16.22 / $25.70	Facility		$2.00	$16.22	$25.70
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $23.99 / $38.90	Professional		$19.95	$23.99	$38.90