Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $117.49 / $467.74	Facility		$79.43	$117.49	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $117.49	Professional		$104.71	$104.71	$117.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $128.82	Facility		$72.44	$72.44	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $114.82	Professional		$91.20	$91.20	$114.82
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 $79.43 / $79.43 / $112.20	Facility		$79.43	$79.43	$112.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $147.91 / $213.80	Facility		$79.43	$147.91	$213.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $95.50	Professional		$72.44	$72.44	$95.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $125.89 / $208.93	Facility		$83.18	$125.89	$208.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $72.44 / $79.43	Professional		$60.26	$72.44	$79.43
United Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $95.50 / $95.50	Facility		$79.43	$95.50	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $44.67 / $104.71	Professional		$43.65	$44.67	$104.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $144.54	Professional		$35.48	$35.48	$144.54