Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $120.23 / $398.11	Facility		$72.44	$120.23	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $56.23 / $102.33	Professional		$50.12	$56.23	$102.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $44.67	Professional		$43.65	$43.65	$44.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $147.91 / $186.21	Facility		$72.44	$147.91	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $75.86 / $104.71	Professional		$36.31	$75.86	$104.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $107.15	Facility		$72.44	$72.44	$107.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $125.89 / $218.78	Facility		$72.44	$125.89	$218.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $87.10	Professional		$64.57	$64.57	$87.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $107.15 / $199.53	Facility		$75.86	$107.15	$199.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $64.57 / $72.44	Professional		$53.70	$64.57	$72.44
United Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $87.10 / $87.10	Facility		$72.44	$87.10	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $72.44	Professional		$30.20	$30.20	$72.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $128.82	Professional		$32.36	$32.36	$128.82