Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Facility		$478.63	$478.63	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $562.34 / $912.01	Professional		$398.11	$562.34	$912.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Facility		$575.44	$575.44	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $489.78 / $575.44	Professional		$75.86	$489.78	$575.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $74.13 / $588.84	Professional		$64.57	$74.13	$588.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,348.96 / $1,412.54	Facility		$1,148.15	$1,348.96	$1,412.54
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,380.38 / $1,412.54	Professional		$1,148.15	$1,380.38	$1,412.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $83.18 / $831.76	Facility		$60.26	$83.18	$831.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $83.18 / $707.95	Professional		$60.26	$83.18	$707.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $138.04 / $138.04	Professional		$114.82	$138.04	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $69.18 / $537.03	Facility		$46.77	$69.18	$537.03
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $91.20 / $776.25	Professional		$46.77	$91.20	$776.25