Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $125.89 / $380.19	Facility		$79.43	$125.89	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $52.48 / $112.20	Professional		$39.81	$52.48	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $83.18	Professional		$66.07	$66.07	$83.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $51.29 / $64.57	Professional		$37.15	$51.29	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $104.71	Facility		$57.54	$57.54	$104.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $102.33 / $173.78	Facility		$57.54	$102.33	$173.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $69.18	Professional		$52.48	$52.48	$69.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $87.10 / $158.49	Facility		$60.26	$87.10	$158.49
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $52.48 / $57.54	Professional		$43.65	$52.48	$57.54
United Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $69.18 / $69.18	Facility		$57.54	$69.18	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $33.11 / $64.57	Professional		$24.55	$33.11	$64.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $26.30 / $104.71	Professional		$26.30	$26.30	$104.71