Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $275.42 / $316.23	Professional		$151.36	$275.42	$316.23
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 $64.57 / $75.86 / $281.84	Professional		$64.57	$75.86	$281.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $331.13	Facility		$323.59	$323.59	$331.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $489.78 / $707.95	Facility		$323.59	$489.78	$707.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $323.59	Professional		$323.59	$323.59	$323.59
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $501.19 / $933.25	Facility		$416.87	$501.19	$933.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Professional		$288.40	$288.40	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $354.81 / $831.76	Professional		$223.87	$354.81	$831.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $512.86	Professional		$288.40	$288.40	$512.86