Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $104.71	Facility		$63.10	$63.10	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $125.89 / $331.13	Professional		$97.72	$125.89	$331.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $128.82	Professional		$87.10	$87.10	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $114.82 / $223.87	Facility		$109.65	$114.82	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Professional		$114.82	$114.82	$114.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $2.69 / $7.08 / $50.12	Professional		$2.69	$7.08	$50.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $128.82 / $128.82	Facility		$107.15	$128.82	$128.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $213.80 / $316.23	Facility		$117.49	$213.80	$316.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $117.49 / $117.49	Professional		$95.50	$117.49	$117.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $95.50 / $181.97	Facility		$79.43	$95.50	$181.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Professional		$109.65	$109.65	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $114.82 / $123.03	Professional		$102.33	$114.82	$123.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Professional		$97.72	$97.72	$97.72