Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $208.93 / $208.93	Facility		$125.89	$208.93	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $158.49	Professional		$125.89	$125.89	$158.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $117.49 / $309.03	Professional		$50.12	$117.49	$309.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $169.82 / $173.78	Facility		$141.25	$169.82	$173.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $117.49	Facility		$107.15	$107.15	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $177.83	Professional		$147.91	$147.91	$177.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Professional		$134.90	$134.90	$134.90