Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $128.82 / $457.09	Facility		$69.18	$128.82	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $57.54 / $102.33	Professional		$40.74	$57.54	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $158.49 / $199.53	Facility		$72.44	$158.49	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $79.43 / $100.00	Professional		$36.31	$79.43	$100.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $131.83	Facility		$69.18	$69.18	$131.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $120.23 / $208.93	Facility		$69.18	$120.23	$208.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $83.18	Professional		$61.66	$61.66	$83.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $102.33 / $190.55	Facility		$72.44	$102.33	$190.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $61.66 / $69.18	Professional		$51.29	$61.66	$69.18
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $83.18 / $83.18	Facility		$69.18	$83.18	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.88 / $69.18	Professional		$28.84	$33.88	$69.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $123.03	Professional		$30.90	$30.90	$123.03