Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $141.25 / $371.54	Facility		$89.13	$141.25	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $57.54 / $354.81	Professional		$42.66	$57.54	$354.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $44.67	Professional		$39.81	$39.81	$44.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $141.25 / $208.93	Facility		$67.61	$141.25	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $74.13 / $128.82	Professional		$39.81	$74.13	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $56.23 / $67.61	Professional		$41.69	$56.23	$67.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $97.72	Facility		$64.57	$64.57	$97.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $112.20 / $194.98	Facility		$64.57	$112.20	$194.98
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $77.62	Professional		$57.54	$57.54	$77.62
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $97.72 / $177.83	Facility		$67.61	$97.72	$177.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $57.54 / $64.57	Professional		$47.86	$57.54	$64.57
United Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $77.62 / $77.62	Facility		$64.57	$77.62	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $37.15 / $72.44	Professional		$26.92	$37.15	$72.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $28.84 / $114.82	Professional		$28.84	$28.84	$114.82