Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $102.33 / $269.15	Facility		$74.13	$102.33	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $97.72 / $177.83	Professional		$63.10	$97.72	$177.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $83.18 / $114.82	Professional		$25.70	$83.18	$114.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $208.93	Facility		$95.50	$95.50	$208.93
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 $50.12 / $97.72 / $263.03	Professional		$50.12	$97.72	$263.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $97.72 / $147.91	Facility		$74.13	$97.72	$147.91
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $147.91 / $213.80	Facility		$95.50	$147.91	$213.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $87.10 / $87.10	Professional		$70.79	$87.10	$87.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $109.65 / $208.93	Facility		$91.20	$109.65	$208.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33
United Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $93.33 / $93.33	Facility		$87.10	$93.33	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $97.72 / $102.33	Professional		$87.10	$97.72	$102.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $128.82	Professional		$66.07	$66.07	$128.82