Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $616.60 / $870.96	Facility		$524.81	$616.60	$870.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $524.81 / $588.84	Professional		$398.11	$524.81	$588.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,819.70 / $2,187.76	Facility		$851.14	$1,819.70	$2,187.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $138.04 / $151.36	Professional		$109.65	$138.04	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $75.86	Professional		$50.12	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $2,089.30 / $2,884.03	Facility		$812.83	$2,089.30	$2,884.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $562.34 / $562.34	Professional		$562.34	$562.34	$562.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $2,454.71 / $4,677.35	Facility		$1,621.81	$2,454.71	$4,677.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $363.08 / $398.11	Professional		$302.00	$363.08	$398.11
United Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $3,019.95 / $5,495.41	Facility		$2,290.87	$3,019.95	$5,495.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Professional		$891.25	$891.25	$891.25