Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $95.50 / $295.12	Facility		$69.18	$95.50	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $44.67 / $128.82	Professional		$33.11	$44.67	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $112.20 / $162.18	Facility		$52.48	$112.20	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $57.54 / $97.72	Professional		$31.62	$57.54	$97.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $44.67 / $64.57	Professional		$32.36	$44.67	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $95.50	Facility		$50.12	$50.12	$95.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $89.13 / $151.36	Facility		$50.12	$89.13	$151.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $60.26	Professional		$45.71	$45.71	$60.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $75.86 / $138.04	Facility		$52.48	$75.86	$138.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $45.71 / $50.12	Professional		$38.02	$45.71	$50.12
United Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $60.26 / $60.26	Facility		$50.12	$60.26	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $25.12 / $56.23	Professional		$21.38	$25.12	$56.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $91.20	Professional		$22.91	$22.91	$91.20