Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $48.98 / $85.11	Professional		$30.20	$48.98	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $107.15 / $138.04	Professional		$87.10	$107.15	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $60.26	Professional		$50.12	$50.12	$60.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $57.54 / $95.50	Facility		$34.67	$57.54	$95.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $57.54 / $91.20	Professional		$34.67	$57.54	$91.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $40.74 / $69.18	Professional		$32.36	$40.74	$69.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $109.65 / $114.82	Facility		$74.13	$109.65	$114.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Facility		$81.28	$81.28	$81.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $89.13 / $144.54	Professional		$52.48	$89.13	$144.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $302.00	Facility		$199.53	$199.53	$302.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $83.18 / $128.82	Professional		$52.48	$83.18	$128.82
United Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $371.54 / $512.86	Facility		$346.74	$371.54	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $81.28 / $144.54	Professional		$45.71	$81.28	$144.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $69.18 / $117.49	Professional		$63.10	$69.18	$117.49