Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2.88 / $7.76 / $93.33	Facility		$2.88	$7.76	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2.00 / $2.51 / $13.49	Professional		$2.00	$2.51	$13.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $3.80 / $3.80 / $3.80	Professional		$3.80	$3.80	$3.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2.40 / $2.40 / $5.89	Facility		$2.40	$2.40	$5.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2.51 / $2.51 / $3.09	Professional		$2.51	$2.51	$3.09
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2.09 / $2.51 / $14.45	Facility		$2.09	$2.51	$14.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2.51 / $3.39 / $15.14	Professional		$2.51	$3.39	$15.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $2.00 / $2.75 / $75.86	Professional		$2.00	$2.75	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1.82 / $2.00 / $3.80	Facility		$1.82	$2.00	$3.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3.80 / $3.80 / $5.62	Facility		$3.80	$3.80	$5.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2.88 / $3.80 / $3.80	Professional		$2.88	$3.80	$3.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2.75 / $2.75 / $2.75	Facility		$2.75	$2.75	$2.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2.51 / $2.75 / $2.75	Professional		$2.51	$2.75	$2.75
United Facility/Professional Professional Modifier Low / Median / High Price $2.51 / $2.51 / $2.95	Professional		$2.51	$2.51	$2.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2.51 / $2.51 / $3.31	Professional		$2.51	$2.51	$3.31