Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $208.93 / $954.99	Facility		$64.57	$208.93	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $54.95 / $147.91	Professional		$52.48	$54.95	$147.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $45.71 / $213.80	Facility		$45.71	$45.71	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $45.71	Professional		$45.71	$45.71	$45.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $66.07 / $100.00	Facility		$52.48	$66.07	$100.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $52.48 / $147.91	Facility		$44.67	$52.48	$147.91
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $45.71 / $48.98	Professional		$41.69	$45.71	$48.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $66.07 / $154.88	Facility		$52.48	$66.07	$154.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Professional		$52.48	$52.48	$52.48
United Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Facility		$52.48	$52.48	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Professional		$52.48	$52.48	$52.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $69.18	Professional		$52.48	$52.48	$69.18