Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $131.83 / $186.21	Professional		$87.10	$131.83	$186.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $104.71 / $229.09	Professional		$100.00	$104.71	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $162.18 / $263.03	Professional		$114.82	$162.18	$263.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $89.13	Professional		$32.36	$33.11	$89.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $245.47 / $251.19	Facility		$177.83	$245.47	$251.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $239.88 / $331.13	Professional		$165.96	$239.88	$331.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $323.59	Professional		$323.59	$323.59	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $204.17 / $346.74	Professional		$147.91	$204.17	$346.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $134.90 / $257.04	Professional		$123.03	$134.90	$257.04