Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $194.98	Facility		$117.49	$117.49	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $154.88 / $181.97	Professional		$117.49	$154.88	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $346.74 / $346.74	Facility		$281.84	$346.74	$346.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $239.88	Facility		$173.78	$173.78	$239.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $371.54 / $512.86	Professional		$239.88	$371.54	$512.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $257.04 / $489.78	Facility		$213.80	$257.04	$489.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $338.84 / $457.09	Professional		$229.09	$338.84	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $194.98 / $446.68	Professional		$165.96	$194.98	$446.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $263.03 / $371.54	Professional		$223.87	$263.03	$371.54