Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $79.43 / $186.21	Facility		$20.89	$79.43	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $19.95 / $60.26	Professional		$16.98	$19.95	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $15.49 / $15.49	Professional		$13.49	$15.49	$15.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $48.98 / $79.43	Facility		$23.44	$48.98	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $32.36 / $66.07	Professional		$23.44	$32.36	$66.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $23.44 / $33.11	Professional		$11.22	$23.44	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $23.44 / $53.70	Facility		$22.39	$23.44	$53.70
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $22.39 / $22.39	Professional		$22.39	$22.39	$22.39
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $38.90 / $67.61	Facility		$22.39	$38.90	$67.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $26.92	Professional		$19.95	$19.95	$26.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $33.88 / $61.66	Facility		$23.44	$33.88	$61.66
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $19.95 / $22.39	Professional		$16.60	$19.95	$22.39
United Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $26.92 / $26.92	Facility		$22.39	$26.92	$26.92
United Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $10.96 / $26.92	Professional		$9.33	$10.96	$26.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $10.00 / $39.81	Professional		$10.00	$10.00	$39.81