Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $87.10 / $208.93	Facility		$28.84	$87.10	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $26.30 / $107.15	Professional		$21.88	$26.30	$107.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $20.42 / $20.42	Professional		$17.78	$20.42	$20.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $61.66 / $93.33	Facility		$26.92	$61.66	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $33.88 / $58.88	Professional		$18.20	$33.88	$58.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $25.70 / $64.57	Professional		$18.62	$25.70	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $29.51 / $54.95	Facility		$29.51	$29.51	$54.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $51.29 / $87.10	Facility		$29.51	$51.29	$87.10
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $26.30 / $35.48	Professional		$26.30	$26.30	$35.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $43.65 / $81.28	Facility		$30.90	$43.65	$81.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $26.30 / $29.51	Professional		$21.88	$26.30	$29.51
United Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $35.48 / $35.48	Facility		$29.51	$35.48	$35.48
United Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $16.60 / $33.11	Professional		$12.30	$16.60	$33.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $13.18 / $52.48	Professional		$13.18	$13.18	$52.48