Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $602.56 / $1,778.28	Facility		$309.03	$602.56	$1,778.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $275.42 / $758.58	Professional		$194.98	$275.42	$758.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $691.83 / $851.14	Facility		$338.84	$691.83	$851.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $331.13 / $467.74	Professional		$97.72	$331.13	$467.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $208.93 / $251.19	Professional		$75.86	$208.93	$251.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $616.60	Facility		$323.59	$323.59	$616.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $575.44 / $977.24	Facility		$323.59	$575.44	$977.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $389.05	Professional		$295.12	$295.12	$389.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $489.78 / $891.25	Facility		$338.84	$489.78	$891.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $295.12 / $323.59	Professional		$245.47	$295.12	$323.59
United Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $389.05 / $389.05	Facility		$323.59	$389.05	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $138.04 / $323.59	Professional		$66.07	$138.04	$323.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $588.84	Professional		$147.91	$147.91	$588.84