Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $23.99 / $23.99	Facility		$23.99	$23.99	$23.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $27.54 / $58.88	Professional		$23.99	$27.54	$58.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $27.54 / $102.33	Facility		$27.54	$27.54	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $27.54 / $27.54	Professional		$27.54	$27.54	$27.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Professional		$50.12	$50.12	$50.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $27.54 / $27.54	Facility		$27.54	$27.54	$27.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $54.95 / $81.28	Facility		$36.31	$54.95	$81.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $29.51 / $29.51	Professional		$23.44	$29.51	$29.51
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $41.69 / $79.43	Facility		$34.67	$41.69	$79.43
United Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $27.54 / $27.54	Facility		$25.70	$27.54	$27.54
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $29.51 / $33.11	Professional		$27.54	$29.51	$33.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $27.54 / $36.31	Professional		$27.54	$27.54	$36.31