Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $208.93	Facility		$87.10	$87.10	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $85.11 / $104.71	Professional		$83.18	$85.11	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $371.54	Facility		$89.13	$89.13	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $75.86	Professional		$64.57	$64.57	$75.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $89.13	Facility		$87.10	$87.10	$89.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $89.13 / $93.33	Professional		$79.43	$89.13	$93.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $100.00	Facility		$89.13	$89.13	$100.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10