Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Facility		$147.91	$147.91	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $154.88 / $478.63	Professional		$141.25	$154.88	$478.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $524.81	Facility		$165.96	$165.96	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Professional		$165.96	$165.96	$165.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $2.69 / $50.12 / $363.08	Professional		$2.69	$50.12	$363.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $128.82 / $128.82	Facility		$107.15	$128.82	$128.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Facility		$177.83	$177.83	$177.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $177.83 / $177.83	Professional		$141.25	$177.83	$177.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $112.20 / $123.03	Facility		$102.33	$112.20	$123.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Professional		$123.03	$123.03	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $165.96 / $186.21	Professional		$147.91	$165.96	$186.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25