Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $109.65 / $131.83	Facility		$61.66	$109.65	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $56.23 / $147.91	Professional		$53.70	$56.23	$147.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $51.29 / $114.82	Facility		$51.29	$51.29	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $66.07	Professional		$54.95	$54.95	$66.07
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 $54.95 / $63.10 / $102.33	Facility		$54.95	$63.10	$102.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $63.10 / $158.49	Facility		$50.12	$63.10	$158.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $58.88 / $64.57	Professional		$54.95	$58.88	$64.57
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $66.07 / $162.18	Facility		$54.95	$66.07	$162.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $56.23 / $70.79	Professional		$54.95	$56.23	$70.79