Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $95.50 / $257.04	Facility		$60.26	$95.50	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $39.81 / $117.49	Professional		$33.11	$39.81	$117.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $97.72 / $141.25	Facility		$45.71	$97.72	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $50.12 / $109.65	Professional		$27.54	$50.12	$109.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $38.90 / $64.57	Professional		$28.18	$38.90	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $43.65 / $97.72	Facility		$43.65	$43.65	$97.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $77.62 / $131.83	Facility		$43.65	$77.62	$131.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $52.48	Professional		$39.81	$39.81	$52.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $66.07 / $120.23	Facility		$45.71	$66.07	$120.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $39.81 / $43.65	Professional		$33.11	$39.81	$43.65
United Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $52.48 / $52.48	Facility		$43.65	$52.48	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $25.12 / $48.98	Professional		$18.62	$25.12	$48.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $79.43	Professional		$19.95	$19.95	$79.43