Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $354.81 / $851.14	Facility		$169.82	$354.81	$851.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $194.98 / $537.03	Professional		$158.49	$194.98	$537.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $128.82 / $213.80	Professional		$95.50	$128.82	$213.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $512.86	Facility		$173.78	$173.78	$512.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $177.83 / $269.15	Facility		$169.82	$177.83	$269.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $309.03 / $467.74	Facility		$208.93	$309.03	$467.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $186.21 / $186.21	Professional		$151.36	$186.21	$186.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $251.19 / $478.63	Facility		$208.93	$251.19	$478.63
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Professional		$169.82	$169.82	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $169.82 / $169.82	Facility		$158.49	$169.82	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $177.83 / $199.53	Professional		$154.88	$177.83	$199.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $229.09	Professional		$151.36	$151.36	$229.09