Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $41.69 / $117.49	Facility		$21.88	$41.69	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $75.86	Professional		$19.95	$19.95	$75.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $19.05 / $131.83	Facility		$19.05	$19.05	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $24.55	Professional		$19.95	$19.95	$24.55
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 $64.57 / $81.28 / $123.03	Facility		$64.57	$81.28	$123.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $85.11 / $275.42	Facility		$79.43	$85.11	$275.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $89.13 / $89.13	Professional		$74.13	$89.13	$89.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $83.18 / $204.17	Facility		$69.18	$83.18	$204.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Professional		$19.95	$19.95	$19.95
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Professional		$19.95	$19.95	$19.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $26.30	Professional		$19.95	$19.95	$26.30