Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Facility		$794.33	$794.33	$794.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $794.33 / $1,000.00	Professional		$467.74	$794.33	$1,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Professional		$295.12	$295.12	$295.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $75.86 / $134.90	Professional		$64.57	$75.86	$134.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $1,174.90	Facility		$758.58	$758.58	$1,174.90
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $1,174.90	Professional		$758.58	$758.58	$1,174.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $954.99 / $1,621.81	Facility		$83.18	$954.99	$1,621.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $165.96 / $741.31	Professional		$74.13	$165.96	$741.31
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,096.48 / $2,089.30	Facility		$912.01	$1,096.48	$2,089.30
United Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,513.56 / $2,398.83	Professional		$645.65	$1,513.56	$2,398.83