Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $66.07 / $194.98	Facility		$20.42	$66.07	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $19.05 / $57.54	Professional		$15.85	$19.05	$57.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $12.88 / $12.88	Professional		$12.88	$12.88	$12.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $45.71 / $67.61	Facility		$21.88	$45.71	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $24.55 / $42.66	Professional		$13.18	$24.55	$42.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $18.62 / $64.57	Professional		$13.49	$18.62	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $21.38 / $35.48	Facility		$21.38	$21.38	$35.48
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $37.15 / $63.10	Facility		$21.38	$37.15	$63.10
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $19.05 / $25.70	Professional		$19.05	$19.05	$25.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $31.62 / $58.88	Facility		$22.39	$31.62	$58.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $19.05 / $21.38	Professional		$15.85	$19.05	$21.38
United Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $25.70 / $25.70	Facility		$21.38	$25.70	$25.70
United Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $10.72 / $23.99	Professional		$8.91	$10.72	$23.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $9.55 / $38.02	Professional		$9.55	$9.55	$38.02