Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $288.40 / $346.74	Facility		$138.04	$288.40	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $269.15	Professional		$138.04	$138.04	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $338.84	Facility		$128.82	$128.82	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Professional		$177.83	$177.83	$177.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $134.90 / $213.80	Facility		$131.83	$134.90	$213.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $190.55 / $389.05	Facility		$131.83	$190.55	$389.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $154.88 / $154.88	Professional		$128.82	$154.88	$154.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $173.78 / $416.87	Facility		$144.54	$173.78	$416.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Professional		$169.82	$169.82	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $154.88 / $199.53	Professional		$138.04	$154.88	$199.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $147.91 / $177.83	Professional		$138.04	$147.91	$177.83