Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $707.95 / $870.96	Facility		$93.33	$707.95	$870.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $1,047.13	Professional		$30.20	$50.12	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $602.56 / $831.76	Professional		$478.63	$602.56	$831.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $95.50 / $331.13	Professional		$64.57	$95.50	$331.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $524.81 / $691.83	Facility		$436.52	$524.81	$691.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $758.58	Professional		$478.63	$478.63	$758.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $645.65 / $794.33	Professional		$537.03	$645.65	$794.33
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 $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78