Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $354.81 / $436.52	Facility		$93.33	$354.81	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $524.81	Professional		$30.20	$50.12	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $269.15 / $363.08	Professional		$213.80	$269.15	$363.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $75.86 / $147.91	Professional		$46.77	$75.86	$147.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $257.04 / $346.74	Facility		$213.80	$257.04	$346.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $338.84	Professional		$213.80	$213.80	$338.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $323.59 / $398.11	Professional		$269.15	$323.59	$398.11
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $58.88 / $83.18	Professional		$44.67	$58.88	$83.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10