Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $85.11 / $154.88	Facility		$83.18	$85.11	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $85.11 / $213.80	Professional		$83.18	$85.11	$213.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $338.84	Facility		$95.50	$95.50	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $75.86	Professional		$30.20	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $199.53 / $199.53	Facility		$165.96	$199.53	$199.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $177.83 / $251.19	Facility		$114.82	$177.83	$251.19
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $100.00 / $100.00	Professional		$81.28	$100.00	$100.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $151.36 / $281.84	Facility		$125.89	$151.36	$281.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Professional		$131.83	$131.83	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $95.50 / $131.83	Professional		$83.18	$95.50	$131.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Professional		$83.18	$83.18	$83.18