Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $134.90 / $141.25	Facility		$79.43	$134.90	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $134.90	Professional		$79.43	$79.43	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $363.08 / $478.63	Facility		$169.82	$363.08	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $75.86	Professional		$50.12	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $416.87 / $691.83	Facility		$162.18	$416.87	$691.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $478.63 / $933.25	Facility		$323.59	$478.63	$933.25
United Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $645.65 / $1,148.15	Facility		$478.63	$645.65	$1,148.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87