Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $239.88 / $524.81	Facility		$48.98	$239.88	$524.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $41.69 / $63.10	Professional		$34.67	$41.69	$63.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $117.49 / $134.90	Facility		$54.95	$117.49	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $75.86	Professional		$60.26	$60.26	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $74.13	Facility		$52.48	$52.48	$74.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $91.20 / $158.49	Facility		$52.48	$91.20	$158.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $63.10	Professional		$47.86	$47.86	$63.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $79.43 / $144.54	Facility		$54.95	$79.43	$144.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $47.86 / $52.48	Professional		$39.81	$47.86	$52.48
United Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $63.10 / $63.10	Facility		$52.48	$63.10	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $22.39 / $52.48	Professional		$22.39	$22.39	$52.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $23.99 / $95.50	Professional		$23.99	$23.99	$95.50