Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $19.05 / $19.05	Professional		$19.05	$19.05	$19.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $4.68 / $4.68 / $4.68	Professional		$4.68	$4.68	$4.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $24.55 / $31.62	Professional		$12.30	$24.55	$31.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $64.57	Professional		$44.67	$50.12	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $47.86 / $47.86	Facility		$39.81	$47.86	$47.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $21.38 / $21.38	Facility		$21.38	$21.38	$21.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $21.38 / $21.38	Professional		$21.38	$21.38	$21.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $32.36 / $32.36	Facility		$32.36	$32.36	$32.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $32.36 / $63.10	Professional		$18.20	$32.36	$63.10
United Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $13.49 / $13.49	Facility		$13.49	$13.49	$13.49
United Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $10.47 / $26.92	Professional		$10.00	$10.47	$26.92