Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $309.03	Professional		$208.93	$208.93	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $645.65 / $691.83	Professional		$512.86	$645.65	$691.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $537.03	Professional		$467.74	$467.74	$537.03
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $275.42 / $295.12	Professional		$257.04	$275.42	$295.12