Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $334.45 / $1,816.01 / $4,387.00	Facility		$334.45	$1,816.01	$4,387.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $835.64 / $2,313.38 / $5,268.00	Facility	50	$835.64	$2,313.38	$5,268.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.12 / $29.12 / $66.89	Facility	53	$29.12	$29.12	$66.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $253.71 / $1,272.44	Professional		$95.09	$253.71	$1,272.44
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.52 / $141.52 / $191.19	Professional	22	$141.52	$141.52	$191.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $150.56 / $361.73 / $2,185.21	Professional	50	$150.56	$361.73	$2,185.21
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $21.94 / $50.74 / $121.43	Professional	53	$21.94	$50.74	$121.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.28 / $236.95 / $414.54	Professional		$132.28	$236.95	$414.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $163.99 / $208.79 / $259.12	Professional		$163.99	$208.79	$259.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,361.81 / $1,728.22 / $2,518.51	Facility		$1,361.81	$1,728.22	$2,518.51
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $2,042.72 / $2,592.33 / $3,777.77	Facility	50	$2,042.72	$2,592.33	$3,777.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $183.76 / $343.73 / $537.37	Professional		$183.76	$343.73	$537.37
United Facility/Professional Facility Modifier Low / Median / High Price $1,106.00 / $1,649.00 / $2,824.00	Facility		$1,106.00	$1,649.00	$2,824.00
United Facility/Professional Professional Modifier Low / Median / High Price $197.44 / $249.01 / $403.80	Professional		$197.44	$249.01	$403.80