Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $47.86 / $177.83	Facility		$12.59	$47.86	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $10.96 / $21.38	Professional		$7.94	$10.96	$21.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $26.92 / $43.65	Facility		$12.59	$26.92	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $26.92 / $45.71	Professional		$16.98	$26.92	$45.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $12.88 / $33.11	Professional		$8.13	$12.88	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $12.59 / $25.12	Facility		$12.02	$12.59	$25.12
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $12.02 / $12.02	Professional		$10.96	$12.02	$12.02
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $20.89 / $36.31	Facility		$12.02	$20.89	$36.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $10.96 / $14.45	Professional		$10.96	$10.96	$14.45
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $18.20 / $33.11	Facility		$12.59	$18.20	$33.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $10.96 / $12.02	Professional		$9.12	$10.96	$12.02
United Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $14.45 / $14.45	Facility		$12.02	$14.45	$14.45
United Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $5.37 / $13.49	Professional		$5.01	$5.37	$13.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $5.37 / $5.37 / $21.88	Professional		$5.37	$5.37	$21.88