Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $1,122.02 / $1,380.38	Facility		$93.33	$1,122.02	$1,380.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $47.86 / $1,659.59	Professional		$30.20	$47.86	$1,659.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,000.00 / $1,380.38	Professional		$794.33	$1,000.00	$1,380.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $158.49 / $562.34	Professional		$64.57	$158.49	$562.34
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $831.76 / $1,202.26	Facility		$741.31	$831.76	$1,202.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $1,258.93	Professional		$794.33	$794.33	$1,258.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,023.29 / $1,288.25	Professional		$851.14	$1,023.29	$1,288.25
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $58.88 / $83.18	Professional		$44.67	$58.88	$83.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Professional		$263.03	$263.03	$263.03