Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $309.03 / $954.99	Facility		$229.09	$309.03	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $141.25 / $323.59	Professional		$109.65	$141.25	$323.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $363.08 / $467.74	Facility		$165.96	$363.08	$467.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $186.21 / $288.40	Professional		$87.10	$186.21	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $128.82 / $173.78	Professional		$75.86	$128.82	$173.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $251.19	Facility		$165.96	$165.96	$251.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $288.40 / $501.19	Facility		$165.96	$288.40	$501.19
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $199.53	Professional		$147.91	$147.91	$199.53
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $251.19 / $457.09	Facility		$173.78	$251.19	$457.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $147.91 / $165.96	Professional		$123.03	$147.91	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $199.53 / $199.53	Facility		$165.96	$199.53	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $77.62 / $186.21	Professional		$69.18	$77.62	$186.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $295.12	Professional		$74.13	$74.13	$295.12