Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $371.54	Facility		$158.49	$158.49	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $154.88 / $158.49	Professional		$147.91	$154.88	$158.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $158.49 / $316.23	Facility		$117.49	$158.49	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Professional		$158.49	$158.49	$158.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $75.86	Professional		$64.57	$64.57	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $47.86 / $54.95	Facility		$47.86	$47.86	$54.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $162.18 / $457.09	Facility		$48.98	$162.18	$457.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $158.49 / $169.82	Professional		$144.54	$158.49	$169.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $194.98 / $478.63	Facility		$162.18	$194.98	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $158.49 / $158.49	Professional		$154.88	$158.49	$158.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36