Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $147.91 / $7,943.28	Facility		$79.43	$147.91	$7,943.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $79.43 / $165.96	Professional		$72.44	$79.43	$165.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $74.13	Professional		$72.44	$72.44	$74.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $74.13 / $144.54	Facility		$69.18	$74.13	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $91.20	Professional		$74.13	$74.13	$91.20
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $85.11 / $181.97	Facility		$74.13	$85.11	$181.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $89.13 / $177.83	Professional		$74.13	$89.13	$177.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $81.28 / $97.72	Professional		$70.79	$81.28	$97.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $114.82	Facility		$72.44	$72.44	$114.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $83.18 / $208.93	Facility		$66.07	$83.18	$208.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $91.20	Professional		$77.62	$77.62	$91.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $87.10 / $208.93	Facility		$72.44	$87.10	$208.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $81.28 / $81.28	Professional		$74.13	$81.28	$81.28
United Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $83.18	Professional		$74.13	$74.13	$83.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $74.13 / $95.50	Professional		$72.44	$74.13	$95.50