Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Facility		$67.61	$67.61	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $74.13	Professional		$67.61	$67.61	$74.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $234.42	Facility		$74.13	$74.13	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Professional		$74.13	$74.13	$74.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $2.69 / $2.69 / $7.08	Professional		$2.69	$2.69	$7.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $34.67 / $34.67	Facility		$28.84	$34.67	$34.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $79.43 / $79.43	Professional		$64.57	$79.43	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $74.13 / $79.43	Professional		$66.07	$74.13	$79.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Professional		$67.61	$67.61	$67.61