Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $104.71 / $363.08	Facility		$54.95	$104.71	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $51.29 / $134.90	Professional		$38.02	$51.29	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $128.82 / $162.18	Facility		$57.54	$128.82	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $64.57 / $79.43	Professional		$28.18	$64.57	$79.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $117.49	Facility		$54.95	$54.95	$117.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $97.72 / $165.96	Facility		$54.95	$97.72	$165.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $66.07	Professional		$50.12	$50.12	$66.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $83.18 / $151.36	Facility		$58.88	$83.18	$151.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $50.12 / $54.95	Professional		$41.69	$50.12	$54.95
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $66.07 / $66.07	Facility		$54.95	$66.07	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $23.44 / $54.95	Professional		$23.44	$23.44	$54.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $100.00	Professional		$25.12	$25.12	$100.00