Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $93.33 / $169.82	Facility		$24.55	$93.33	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $23.44 / $39.81	Professional		$16.98	$23.44	$39.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $57.54 / $83.18	Facility		$26.92	$57.54	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $29.51 / $51.29	Professional		$16.22	$29.51	$51.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $22.91 / $64.57	Professional		$16.60	$22.91	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $57.54	Facility		$25.70	$25.70	$57.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $44.67 / $77.62	Facility		$25.70	$44.67	$77.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $23.44 / $30.90	Professional		$23.44	$23.44	$30.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $38.90 / $70.79	Facility		$26.92	$38.90	$70.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $23.44 / $25.70	Professional		$19.50	$23.44	$25.70
United Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $30.90 / $30.90	Facility		$25.70	$30.90	$30.90
United Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $14.79 / $28.84	Professional		$10.96	$14.79	$28.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $11.48 / $46.77	Professional		$11.48	$11.48	$46.77