Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $131.83 / $7,244.36	Facility		$77.62	$131.83	$7,244.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $79.43 / $208.93	Professional		$75.86	$79.43	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $70.79 / $147.91	Facility		$70.79	$70.79	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $93.33	Professional		$75.86	$75.86	$93.33
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 $75.86 / $95.50 / $144.54	Facility		$75.86	$95.50	$144.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $79.43 / $186.21	Facility		$60.26	$79.43	$186.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $77.62 / $85.11	Professional		$72.44	$77.62	$85.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $83.18 / $199.53	Facility		$69.18	$83.18	$199.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
United Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Facility		$75.86	$75.86	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $97.72	Professional		$75.86	$75.86	$97.72