Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $53.70 / $72.44	Professional		$33.11	$53.70	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $69.18 / $100.00	Professional		$47.86	$69.18	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $38.02	Professional		$32.36	$33.11	$38.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $97.72 / $104.71	Facility		$79.43	$97.72	$104.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $70.79 / $70.79	Facility		$63.10	$70.79	$70.79
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $93.33 / $125.89	Professional		$66.07	$93.33	$125.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $87.10 / $147.91	Professional		$60.26	$87.10	$147.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $95.50	Professional		$50.12	$50.12	$95.50