Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $630.96 / $776.25	Facility		$93.33	$630.96	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $47.86 / $933.25	Professional		$30.20	$47.86	$933.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $537.03 / $741.31	Professional		$426.58	$537.03	$741.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $85.11 / $295.12	Professional		$64.57	$85.11	$295.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $467.74 / $616.60	Facility		$380.19	$467.74	$616.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $676.08	Professional		$426.58	$426.58	$676.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $575.44 / $724.44	Professional		$478.63	$575.44	$724.44
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 $169.82 / $169.82 / $169.82	Professional		$169.82	$169.82	$169.82