Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $426.58 / $524.81	Facility		$93.33	$426.58	$524.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $630.96	Professional		$30.20	$50.12	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $331.13 / $457.09	Professional		$263.03	$331.13	$457.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $75.86 / $186.21	Professional		$58.88	$75.86	$186.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $309.03 / $416.87	Facility		$257.04	$309.03	$416.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $416.87	Professional		$269.15	$269.15	$416.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $389.05 / $478.63	Professional		$323.59	$389.05	$478.63
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 $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20