Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $3,019.95 / $3,019.95	Facility		$3,019.95	$3,019.95	$3,019.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $3,019.95 / $3,467.37	Professional		$1,659.59	$3,019.95	$3,467.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,698.24 / $1,698.24	Professional		$1,698.24	$1,698.24	$1,698.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $398.11 / $3,090.30	Professional		$64.57	$398.11	$3,090.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $3,548.13 / $3,630.78	Facility		$3,548.13	$3,548.13	$3,630.78
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,548.13 / $3,548.13 / $3,630.78	Professional		$3,548.13	$3,548.13	$3,630.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $4,570.88 / $7,244.36	Facility		$562.34	$4,570.88	$7,244.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $1,023.29 / $3,548.13	Professional		$562.34	$1,023.29	$3,548.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,570.88 / $5,495.41 / $10,471.29	Facility		$4,570.88	$5,495.41	$10,471.29
United Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $3,890.45 / $9,332.54	Professional		$2,511.89	$3,890.45	$9,332.54