Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $169.82 / $537.03	Facility		$125.89	$169.82	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $83.18 / $177.83	Professional		$61.66	$83.18	$177.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $204.17 / $295.12	Facility		$95.50	$204.17	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $104.71 / $190.55	Professional		$57.54	$104.71	$190.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $75.86 / $97.72	Professional		$58.88	$75.86	$97.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $138.04	Facility		$91.20	$91.20	$138.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $158.49 / $275.42	Facility		$91.20	$158.49	$275.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $109.65	Professional		$81.28	$81.28	$109.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $138.04 / $251.19	Facility		$95.50	$138.04	$251.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $81.28 / $91.20	Professional		$67.61	$81.28	$91.20
United Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $109.65 / $109.65	Facility		$91.20	$109.65	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $45.71 / $102.33	Professional		$38.02	$45.71	$102.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $40.74 / $165.96	Professional		$40.74	$40.74	$165.96