Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $74.13 / $104.71	Facility		$46.77	$74.13	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $43.65 / $53.70	Professional		$42.66	$43.65	$53.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $40.74 / $100.00	Facility		$40.74	$40.74	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $53.70	Professional		$43.65	$43.65	$53.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $75.86	Professional		$64.57	$64.57	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $53.70 / $87.10	Facility		$43.65	$53.70	$87.10
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $39.81 / $50.12	Facility		$39.81	$39.81	$50.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $39.81 / $39.81	Professional		$33.11	$39.81	$39.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Facility		$43.65	$43.65	$43.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Professional		$43.65	$43.65	$43.65
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Professional		$43.65	$43.65	$43.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $56.23	Professional		$43.65	$43.65	$56.23