Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $331.13 / $426.58	Facility		$162.18	$331.13	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $281.84	Professional		$162.18	$162.18	$281.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $162.18 / $323.59	Facility		$154.88	$162.18	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $263.03	Facility		$141.25	$141.25	$263.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $281.84 / $436.52	Facility		$177.83	$281.84	$436.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $173.78 / $173.78	Professional		$141.25	$173.78	$173.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $208.93 / $398.11	Facility		$177.83	$208.93	$398.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Professional		$213.80	$213.80	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $109.65 / $109.65	Facility		$102.33	$109.65	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $162.18 / $181.97	Professional		$144.54	$162.18	$181.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $213.80	Professional		$141.25	$141.25	$213.80