Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $54.95 / $79.43	Professional		$30.90	$54.95	$79.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $42.66	Professional		$39.81	$39.81	$42.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $69.18 / $93.33	Professional		$48.98	$69.18	$93.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $33.11 / $35.48	Professional		$31.62	$33.11	$35.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $89.13 / $104.71	Facility		$74.13	$89.13	$104.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $70.79 / $70.79	Facility		$58.88	$70.79	$70.79
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $85.11 / $114.82	Professional		$61.66	$85.11	$114.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Professional		$114.82	$114.82	$114.82
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 $46.77 / $46.77 / $89.13	Professional		$46.77	$46.77	$89.13