Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $28.84 / $28.84	Facility		$28.84	$28.84	$28.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $28.84 / $33.88	Professional		$15.85	$28.84	$33.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $16.22 / $16.22	Professional		$16.22	$16.22	$16.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $75.86	Professional		$30.20	$30.20	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $36.31	Facility		$35.48	$35.48	$36.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $52.48 / $77.62	Facility		$35.48	$52.48	$77.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $35.48	Professional		$35.48	$35.48	$35.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $53.70 / $102.33	Facility		$44.67	$53.70	$102.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $30.90	Professional		$30.90	$30.90	$30.90
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $38.02 / $91.20	Professional		$32.36	$38.02	$91.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $54.95	Professional		$30.90	$30.90	$54.95