Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $57.54 / $134.90	Facility		$18.20	$57.54	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $58.88 / $234.42	Professional		$40.74	$58.88	$234.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $75.86 / $128.82	Professional		$44.67	$75.86	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $75.86	Facility		$67.61	$67.61	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $75.86	Professional		$48.98	$48.98	$75.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $125.89 / $331.13	Facility		$60.26	$125.89	$331.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $117.49 / $169.82	Professional		$56.23	$117.49	$169.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $95.50 / $107.15	Professional		$75.86	$95.50	$107.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $83.18 / $100.00	Facility		$61.66	$83.18	$100.00
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $63.10 / $100.00	Professional		$61.66	$63.10	$100.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $89.13 / $141.25	Facility		$70.79	$89.13	$141.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $70.79	Professional		$51.29	$51.29	$70.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $87.10	Professional		$53.70	$53.70	$87.10
United Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $181.97 / $181.97	Facility		$48.98	$181.97	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $48.98 / $81.28	Professional		$45.71	$48.98	$81.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $53.70 / $95.50	Professional		$44.67	$53.70	$95.50