Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $63.10 / $245.47	Facility		$41.69	$63.10	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $50.12	Professional		$41.69	$41.69	$50.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $87.10 / $109.65	Facility		$28.84	$87.10	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $44.67 / $60.26	Professional		$22.39	$44.67	$60.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $41.69 / $63.10	Facility		$41.69	$41.69	$63.10
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $74.13 / $125.89	Facility		$41.69	$74.13	$125.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $38.02 / $50.12	Professional		$38.02	$38.02	$50.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $63.10 / $112.20	Facility		$44.67	$63.10	$112.20
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $38.02 / $41.69	Professional		$31.62	$38.02	$41.69
United Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $50.12 / $50.12	Facility		$41.69	$50.12	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $17.78 / $42.66	Professional		$17.78	$17.78	$42.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $19.05 / $75.86	Professional		$19.05	$19.05	$75.86