Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $25.12 / $245.47	Facility		$17.38	$25.12	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $12.59 / $34.67	Professional		$12.02	$12.59	$34.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $11.75 / $11.75 / $29.51	Facility		$11.75	$11.75	$29.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $12.59 / $15.85	Professional		$12.59	$12.59	$15.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $14.45 / $64.57	Professional		$12.59	$14.45	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $14.45 / $16.22 / $24.55	Facility		$14.45	$16.22	$24.55
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $53.70 / $199.53	Facility		$21.88	$53.70	$199.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $21.88 / $21.88	Professional		$14.45	$21.88	$21.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $12.59 / $14.79	Facility		$12.59	$12.59	$14.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $12.59 / $14.45	Professional		$12.59	$12.59	$14.45
United Facility/Professional Facility Modifier Low / Median / High Price $0.15 / $0.16 / $1.58	Facility		$0.15	$0.16	$1.58
United Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $12.59 / $12.59	Professional		$5.01	$12.59	$12.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $12.59 / $16.22	Professional		$12.59	$12.59	$16.22