Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $2,344.23	Facility		$2,344.23	$2,344.23	$2,344.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $2,344.23	Professional		$2,344.23	$2,344.23	$2,344.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $5,495.41	Facility		$2,570.40	$2,570.40	$5,495.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $2,570.40	Professional		$2,570.40	$2,570.40	$2,570.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $75.86	Professional		$32.36	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $204.17 / $204.17	Facility		$169.82	$204.17	$204.17
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $2,754.23 / $6,309.57	Facility		$1,949.84	$2,754.23	$6,309.57
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $2,754.23 / $2,754.23	Professional		$2,238.72	$2,754.23	$2,754.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,691.53 / $6,606.93	Facility		$2,238.72	$2,691.53	$6,606.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $2,454.71 / $2,454.71	Professional		$2,454.71	$2,454.71	$2,454.71
United Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $2,344.23	Facility		$2,344.23	$2,344.23	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $2,754.23 / $3,019.95	Professional		$2,344.23	$2,754.23	$3,019.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $144.54 / $2,187.76	Professional		$109.65	$144.54	$2,187.76