Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $57.54 / $302.00	Facility		$42.66	$57.54	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $42.66	Professional		$41.69	$41.69	$42.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $87.10 / $109.65	Facility		$29.51	$87.10	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $60.26	Professional		$48.98	$48.98	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $58.88	Facility		$42.66	$42.66	$58.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $74.13 / $125.89	Facility		$42.66	$74.13	$125.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $38.02 / $51.29	Professional		$38.02	$38.02	$51.29
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $63.10 / $112.20	Facility		$44.67	$63.10	$112.20
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $38.02 / $42.66	Professional		$36.31	$38.02	$42.66
United Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $51.29 / $51.29	Facility		$42.66	$51.29	$51.29
United Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $17.78 / $42.66	Professional		$17.78	$17.78	$42.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $19.05 / $75.86	Professional		$19.05	$19.05	$75.86