Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $218.78 / $954.99	Facility		$131.83	$218.78	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $77.62 / $141.25	Professional		$66.07	$77.62	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $218.78 / $281.84	Facility		$100.00	$218.78	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $100.00 / $138.04	Professional		$50.12	$100.00	$138.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $74.13 / $75.86	Professional		$61.66	$74.13	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $181.97	Facility		$95.50	$95.50	$181.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $165.96 / $288.40	Facility		$95.50	$165.96	$288.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $114.82	Professional		$85.11	$85.11	$114.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $144.54 / $263.03	Facility		$100.00	$144.54	$263.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $85.11 / $95.50	Professional		$72.44	$85.11	$95.50
United Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $114.82 / $114.82	Facility		$95.50	$114.82	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $45.71 / $107.15	Professional		$39.81	$45.71	$107.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $42.66 / $173.78	Professional		$42.66	$42.66	$173.78