Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $239.88 / $1,905.46	Facility		$117.49	$239.88	$1,905.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $87.10 / $162.18	Professional		$64.57	$87.10	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $245.47 / $323.59	Facility		$104.71	$245.47	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $114.82 / $158.49	Professional		$56.23	$114.82	$158.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $109.65	Professional		$32.36	$33.11	$109.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $208.93	Facility		$109.65	$109.65	$208.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $190.55 / $331.13	Facility		$109.65	$190.55	$331.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $131.83	Professional		$97.72	$97.72	$131.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $165.96 / $302.00	Facility		$114.82	$165.96	$302.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $97.72 / $109.65	Professional		$81.28	$97.72	$109.65
United Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $131.83 / $131.83	Facility		$109.65	$131.83	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $114.82	Professional		$45.71	$45.71	$114.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $194.98	Professional		$48.98	$48.98	$194.98