Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $295.12 / $741.31	Facility		$177.83	$295.12	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $117.49 / $199.53	Professional		$97.72	$117.49	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $288.40 / $436.52	Facility		$89.13	$288.40	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $154.88 / $275.42	Professional		$85.11	$154.88	$275.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $64.57 / $134.90	Professional		$32.36	$64.57	$134.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $257.04	Facility		$134.90	$134.90	$257.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $239.88 / $407.38	Facility		$134.90	$239.88	$407.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $162.18	Professional		$123.03	$123.03	$162.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $204.17 / $371.54	Facility		$141.25	$204.17	$371.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $123.03 / $134.90	Professional		$102.33	$123.03	$134.90
United Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $162.18 / $162.18	Facility		$134.90	$162.18	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $57.54 / $134.90	Professional		$40.74	$57.54	$134.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $245.47	Professional		$61.66	$61.66	$245.47