Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $228.97 / $228.97 / $228.97	Facility		$228.97	$228.97	$228.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.08 / $223.13 / $273.64	Professional		$206.08	$223.13	$273.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.50 / $100.50 / $187.54	Professional		$100.50	$100.50	$187.54
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $60.08 / $207.49 / $249.39	Professional		$60.08	$207.49	$249.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.81 / $65.81 / $65.81	Professional		$65.81	$65.81	$65.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $264.13 / $79,999.20 / $79,999.20	Facility		$264.13	$79,999.20	$79,999.20
United Facility/Professional Professional Modifier Low / Median / High Price $207.49 / $207.49 / $214.78	Professional		$207.49	$207.49	$214.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $207.49 / $272.06 / $272.06	Professional		$207.49	$272.06	$272.06