Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $125.89 / $363.08	Facility		$52.48	$125.89	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $45.71 / $125.89	Professional		$35.48	$45.71	$125.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $79.43	Professional		$70.79	$70.79	$79.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $48.98	Professional		$35.48	$35.48	$48.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $112.20 / $223.87	Facility		$47.86	$112.20	$223.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $97.72 / $177.83	Professional		$47.86	$97.72	$177.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $60.26 / $67.61	Professional		$54.95	$60.26	$67.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $77.62 / $100.00	Facility		$63.10	$77.62	$100.00
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $79.43 / $100.00	Professional		$70.79	$79.43	$100.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $117.49 / $169.82	Facility		$69.18	$117.49	$169.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $87.10	Professional		$66.07	$66.07	$87.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Facility		$77.62	$77.62	$77.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $89.13	Professional		$69.18	$69.18	$89.13
United Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $123.03 / $123.03	Facility		$37.15	$123.03	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $40.74 / $72.44	Professional		$35.48	$40.74	$72.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $69.18 / $120.23	Professional		$56.23	$69.18	$120.23