Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $158.49 / $354.81	Facility		$95.50	$158.49	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $93.33 / $120.23	Professional		$89.13	$93.33	$120.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $158.49	Facility		$95.50	$95.50	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $69.18 / $75.86	Professional		$63.10	$69.18	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $75.86 / $144.54	Facility		$69.18	$75.86	$144.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $125.89 / $181.97	Facility		$87.10	$125.89	$181.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $87.10 / $95.50	Professional		$83.18	$87.10	$95.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
United Facility/Professional Facility Modifier Low / Median / High Price $0.08 / $0.79 / $7.94	Facility		$0.08	$0.79	$7.94
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $89.13 / $89.13	Professional		$36.31	$89.13	$89.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Professional		$79.43	$79.43	$79.43