Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $281.84 / $346.74	Facility		$93.33	$281.84	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $416.87	Professional		$30.20	$50.12	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $199.53 / $275.42	Professional		$158.49	$199.53	$275.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $69.18 / $112.20	Professional		$34.67	$69.18	$112.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $208.93 / $275.42	Facility		$169.82	$208.93	$275.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $251.19	Professional		$162.18	$162.18	$251.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $257.04 / $323.59	Professional		$213.80	$257.04	$323.59
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 $69.18 / $69.18 / $69.18	Professional		$69.18	$69.18	$69.18