Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5.37 / $21.88 / $53.70	Facility		$5.37	$21.88	$53.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $21.88 / $30.90	Professional		$21.38	$21.88	$30.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $21.88 / $23.99	Professional		$18.62	$21.88	$23.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $21.88 / $72.44	Facility		$21.88	$21.88	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $21.88 / $21.88	Professional		$21.88	$21.88	$21.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $2.69 / $21.88 / $54.95	Professional		$2.69	$21.88	$54.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $23.44 / $38.90	Facility		$21.88	$23.44	$38.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $38.02 / $43.65	Facility		$22.91	$38.02	$43.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $22.91 / $22.91	Professional		$18.62	$22.91	$22.91
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $16.60 / $19.95 / $38.02	Facility		$16.60	$19.95	$38.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $22.39 / $22.39	Professional		$22.39	$22.39	$22.39
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $22.91 / $23.99	Professional		$19.95	$22.91	$23.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $21.88 / $28.84	Professional		$21.88	$21.88	$28.84