Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $776.25 / $954.99	Facility		$93.33	$776.25	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $1,174.90	Professional		$30.20	$50.12	$1,174.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $676.08 / $912.01	Professional		$524.81	$676.08	$912.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $107.15 / $371.54	Professional		$64.57	$107.15	$371.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $575.44 / $758.58	Facility		$467.74	$575.44	$758.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $537.03 / $831.76	Professional		$537.03	$537.03	$831.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $707.95 / $870.96	Professional		$588.84	$707.95	$870.96
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 $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17