Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $288.40 / $457.09	Facility		$190.55	$288.40	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $338.84	Professional		$190.55	$190.55	$338.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $316.23	Facility		$190.55	$190.55	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $181.97 / $288.40	Facility		$147.91	$181.97	$288.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $309.03 / $426.58	Facility		$194.98	$309.03	$426.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $169.82 / $169.82	Professional		$138.04	$169.82	$169.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $223.87 / $426.58	Facility		$186.21	$223.87	$426.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Professional		$181.97	$181.97	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $181.97 / $181.97	Facility		$169.82	$181.97	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $190.55 / $204.17	Professional		$169.82	$190.55	$204.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $257.04 / $363.08	Professional		$190.55	$257.04	$363.08