Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $9.55 / $15.85 / $22.91	Facility		$9.55	$15.85	$22.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.59 / $8.91 / $10.96	Professional		$7.59	$8.91	$10.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8.71 / $8.71 / $16.98	Facility		$8.71	$8.71	$16.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $9.12 / $11.22	Professional		$9.12	$9.12	$11.22
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 $8.91 / $10.47 / $16.98	Facility		$8.91	$10.47	$16.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $10.23 / $11.48	Facility		$10.23	$10.23	$11.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $10.23 / $10.23	Professional		$8.51	$10.23	$10.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $9.12 / $9.12 / $9.12	Facility		$9.12	$9.12	$9.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $9.12 / $9.12	Professional		$9.12	$9.12	$9.12
United Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $9.12 / $9.12	Professional		$9.12	$9.12	$9.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $9.12 / $12.02	Professional		$9.12	$9.12	$12.02