Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $102.33 / $354.81	Facility		$53.70	$102.33	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $48.98 / $125.89	Professional		$35.48	$48.98	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $125.89 / $186.21	Facility		$56.23	$125.89	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $61.66 / $77.62	Professional		$27.54	$61.66	$77.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $114.82	Facility		$53.70	$53.70	$114.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $95.50 / $162.18	Facility		$53.70	$95.50	$162.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $64.57	Professional		$48.98	$48.98	$64.57
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $81.28 / $147.91	Facility		$57.54	$81.28	$147.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $48.98 / $53.70	Professional		$40.74	$48.98	$53.70
United Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $64.57 / $64.57	Facility		$53.70	$64.57	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $53.70	Professional		$22.91	$22.91	$53.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $24.55 / $97.72	Professional		$24.55	$24.55	$97.72