Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $120.23 / $323.59	Facility		$75.86	$120.23	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $52.48 / $251.19	Professional		$41.69	$52.48	$251.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $123.03 / $177.83	Facility		$57.54	$123.03	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $58.88 / $85.11	Professional		$29.51	$58.88	$85.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $48.98 / $64.57	Professional		$35.48	$48.98	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $56.23 / $95.50	Facility		$56.23	$56.23	$95.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $97.72 / $165.96	Facility		$56.23	$97.72	$165.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $67.61	Professional		$50.12	$50.12	$67.61
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $83.18 / $154.88	Facility		$58.88	$83.18	$154.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $50.12 / $56.23	Professional		$41.69	$50.12	$56.23
United Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $67.61 / $67.61	Facility		$56.23	$67.61	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $29.51 / $63.10	Professional		$23.44	$29.51	$63.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $100.00	Professional		$25.12	$25.12	$100.00