Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $489.78 / $602.56	Facility		$93.33	$489.78	$602.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $741.31	Professional		$30.20	$50.12	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $398.11 / $549.54	Professional		$316.23	$398.11	$549.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $75.86 / $223.87	Professional		$63.10	$75.86	$223.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $363.08 / $524.81	Facility		$331.13	$363.08	$524.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $501.19	Professional		$323.59	$323.59	$501.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $446.68 / $562.34	Professional		$371.54	$446.68	$562.34
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 $120.23 / $120.23 / $120.23	Professional		$120.23	$120.23	$120.23