Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $77.62 / $173.78	Facility		$15.85	$77.62	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $12.88 / $19.95	Professional		$10.96	$12.88	$19.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $38.02 / $44.67	Facility		$17.78	$38.02	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $24.55	Professional		$19.95	$19.95	$24.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $17.38 / $23.99	Facility		$17.38	$17.38	$23.99
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $30.20 / $51.29	Facility		$17.38	$30.20	$51.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $15.49 / $20.89	Professional		$15.49	$15.49	$20.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $25.70 / $47.86	Facility		$18.20	$25.70	$47.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $15.49 / $17.38	Professional		$12.88	$15.49	$17.38
United Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $20.89 / $20.89	Facility		$17.38	$20.89	$20.89
United Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $7.24 / $17.38	Professional		$7.24	$7.24	$17.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $7.76 / $7.76 / $30.90	Professional		$7.76	$7.76	$30.90