Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $24.55 / $67.61	Facility		$10.00	$24.55	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $22.91 / $53.70	Professional		$10.47	$22.91	$53.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7.41 / $7.41 / $7.41	Professional		$7.41	$7.41	$7.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $30.90 / $54.95	Facility		$18.62	$30.90	$54.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $30.90 / $50.12	Professional		$18.62	$30.90	$50.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $32.36 / $60.26	Professional		$18.20	$32.36	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $17.78 / $19.05	Facility		$17.78	$17.78	$19.05
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $14.45 / $14.45	Professional		$14.45	$14.45	$14.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $33.11 / $47.86	Facility		$22.39	$33.11	$47.86
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $15.14 / $17.78	Professional		$15.14	$15.14	$17.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $15.85 / $20.42	Professional		$15.85	$15.85	$20.42
United Facility/Professional Professional Modifier Low / Median / High Price $6.03 / $7.76 / $14.79	Professional		$6.03	$7.76	$14.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $15.85 / $28.18	Professional		$15.85	$15.85	$28.18