Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $51.29 / $158.49	Facility		$26.92	$51.29	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $21.88 / $39.81	Professional		$18.20	$21.88	$39.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $54.95 / $70.79	Facility		$27.54	$54.95	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $28.84 / $38.90	Professional		$14.13	$28.84	$38.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $26.92 / $40.74	Facility		$26.92	$26.92	$40.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $47.86 / $81.28	Facility		$26.92	$47.86	$81.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $24.55 / $32.36	Professional		$24.55	$24.55	$32.36
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $40.74 / $74.13	Facility		$28.18	$40.74	$74.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $24.55 / $26.92	Professional		$20.42	$24.55	$26.92
United Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $32.36 / $32.36	Facility		$26.92	$32.36	$32.36
United Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $11.48 / $26.92	Professional		$11.48	$11.48	$26.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $12.30 / $48.98	Professional		$12.30	$12.30	$48.98