Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $281.84 / $616.60	Facility		$57.54	$281.84	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $48.98 / $74.13	Professional		$40.74	$48.98	$74.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $138.04 / $162.18	Facility		$64.57	$138.04	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $89.13	Professional		$70.79	$70.79	$89.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $67.61 / $109.65	Facility		$56.23	$67.61	$109.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $109.65 / $186.21	Facility		$61.66	$109.65	$186.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $74.13	Professional		$56.23	$56.23	$74.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $93.33 / $169.82	Facility		$64.57	$93.33	$169.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $56.23 / $61.66	Professional		$46.77	$56.23	$61.66
United Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $74.13 / $74.13	Facility		$61.66	$74.13	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $26.30 / $61.66	Professional		$26.30	$26.30	$61.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $28.18 / $112.20	Professional		$28.18	$28.18	$112.20