Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $338.84 / $407.38	Facility		$204.17	$338.84	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $199.53 / $245.47	Professional		$194.98	$199.53	$245.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $371.54	Facility		$186.21	$186.21	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $239.88	Professional		$194.98	$194.98	$239.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $194.98 / $288.40	Facility		$181.97	$194.98	$288.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $208.93 / $501.19	Facility		$165.96	$208.93	$501.19
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $199.53 / $218.78	Professional		$186.21	$199.53	$218.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $218.78 / $524.81	Facility		$181.97	$218.78	$524.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Professional		$194.98	$194.98	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Professional		$194.98	$194.98	$194.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $257.04	Professional		$194.98	$194.98	$257.04