Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $389.05 / $1,230.27	Facility		$269.15	$389.05	$1,230.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $177.83 / $407.38	Professional		$125.89	$177.83	$407.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $467.74 / $549.54	Facility		$169.82	$467.74	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $218.78 / $302.00	Professional		$97.72	$218.78	$302.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $162.18 / $223.87	Professional		$75.86	$162.18	$223.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $316.23	Facility		$208.93	$208.93	$316.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $363.08 / $630.96	Facility		$208.93	$363.08	$630.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $251.19	Professional		$190.55	$190.55	$251.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $316.23 / $575.44	Facility		$218.78	$316.23	$575.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $190.55 / $208.93	Professional		$158.49	$190.55	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $251.19 / $251.19	Facility		$208.93	$251.19	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $87.10 / $208.93	Professional		$77.62	$87.10	$208.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $380.19	Professional		$93.33	$93.33	$380.19