Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $79.43 / $114.82	Professional		$52.48	$79.43	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $100.00 / $162.18	Professional		$70.79	$100.00	$162.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $60.26	Professional		$32.36	$33.11	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $151.36 / $154.88	Facility		$114.82	$151.36	$154.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $147.91 / $194.98	Professional		$100.00	$147.91	$194.98
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $123.03 / $213.80	Professional		$95.50	$123.03	$213.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $79.43 / $151.36	Professional		$75.86	$79.43	$151.36