Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $331.13 / $457.09	Facility		$275.42	$331.13	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $275.42 / $812.83	Professional		$104.71	$275.42	$812.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $371.54 / $489.78	Facility		$169.82	$371.54	$489.78
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 / $1,148.15	Facility		$162.18	$416.87	$1,148.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $501.19 / $954.99	Facility		$371.54	$501.19	$954.99
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