Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $562.34 / $691.83	Facility		$93.33	$562.34	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $47.86 / $831.76	Professional		$30.20	$47.86	$831.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $467.74 / $645.65	Professional		$371.54	$467.74	$645.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $81.28 / $257.04	Professional		$64.57	$81.28	$257.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $416.87 / $602.56	Facility		$371.54	$416.87	$602.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $588.84	Professional		$371.54	$371.54	$588.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $512.86 / $645.65	Professional		$426.58	$512.86	$645.65
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 $138.04 / $138.04 / $138.04	Professional		$138.04	$138.04	$138.04