Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $331.13 / $1,047.13	Facility		$245.47	$331.13	$1,047.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $144.54 / $263.03	Professional		$117.49	$144.54	$263.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $407.38 / $457.09	Facility		$186.21	$407.38	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $186.21 / $257.04	Professional		$89.13	$186.21	$257.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $75.86	Professional		$64.57	$64.57	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $338.84	Facility		$177.83	$177.83	$338.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $309.03 / $537.03	Facility		$177.83	$309.03	$537.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $213.80	Professional		$158.49	$158.49	$213.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $269.15 / $489.78	Facility		$186.21	$269.15	$489.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $158.49 / $177.83	Professional		$131.83	$158.49	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $213.80 / $213.80	Facility		$177.83	$213.80	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $177.83	Professional		$74.13	$74.13	$177.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $316.23	Professional		$79.43	$79.43	$316.23