Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $72.44 / $199.53	Facility		$46.77	$72.44	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $30.90 / $66.07	Professional		$25.12	$30.90	$66.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $75.86 / $109.65	Facility		$35.48	$75.86	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $38.90 / $67.61	Professional		$20.89	$38.90	$67.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $30.20 / $64.57	Professional		$21.88	$30.20	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $33.88 / $64.57	Facility		$33.88	$33.88	$64.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $58.88 / $102.33	Facility		$33.88	$58.88	$102.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $40.74	Professional		$30.90	$30.90	$40.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $51.29 / $93.33	Facility		$35.48	$51.29	$93.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $30.90 / $33.88	Professional		$25.70	$30.90	$33.88
United Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $40.74 / $40.74	Facility		$33.88	$40.74	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $16.98 / $38.02	Professional		$14.13	$16.98	$38.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $15.14 / $61.66	Professional		$15.14	$15.14	$61.66