Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $63.10 / $363.08	Facility		$51.29	$63.10	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $41.69	Professional		$41.69	$41.69	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $104.71 / $131.83	Facility		$28.84	$104.71	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $74.13	Professional		$58.88	$58.88	$74.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $51.29 / $72.44	Facility		$51.29	$51.29	$72.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $89.13 / $154.88	Facility		$51.29	$89.13	$154.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $61.66	Professional		$46.77	$46.77	$61.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $77.62 / $134.90	Facility		$53.70	$77.62	$134.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $46.77 / $51.29	Professional		$43.65	$46.77	$51.29
United Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $61.66 / $61.66	Facility		$51.29	$61.66	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $18.62 / $51.29	Professional		$17.78	$18.62	$51.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $93.33	Professional		$22.91	$22.91	$93.33