Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $56.23 / $173.78	Facility		$40.74	$56.23	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $22.91 / $47.86	Professional		$19.95	$22.91	$47.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $66.07 / $81.28	Facility		$28.84	$66.07	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $42.66 / $66.07	Professional		$24.55	$42.66	$66.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $31.62 / $33.11	Professional		$11.22	$31.62	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $31.62 / $56.23	Facility		$30.20	$31.62	$56.23
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $30.20 / $30.20	Professional		$26.92	$30.20	$30.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $52.48 / $89.13	Facility		$30.20	$52.48	$89.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $26.92 / $36.31	Professional		$26.92	$26.92	$36.31
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $44.67 / $83.18	Facility		$31.62	$44.67	$83.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $26.92 / $30.20	Professional		$22.39	$26.92	$30.20
United Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $36.31 / $36.31	Facility		$30.20	$36.31	$36.31
United Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $12.59 / $33.88	Professional		$12.59	$12.59	$33.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $13.49 / $53.70	Professional		$13.49	$13.49	$53.70