Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Facility		$269.15	$269.15	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $288.40 / $501.19	Professional		$269.15	$288.40	$501.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Facility		$338.84	$338.84	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $288.40 / $338.84	Professional		$46.77	$288.40	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $75.86	Professional		$64.57	$64.57	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $524.81 / $616.60	Facility		$512.86	$524.81	$616.60
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $616.60 / $616.60	Professional		$512.86	$616.60	$616.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $46.77 / $467.74	Facility		$41.69	$46.77	$467.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $58.88 / $467.74	Professional		$41.69	$58.88	$467.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $53.70 / $53.70	Professional		$44.67	$53.70	$53.70
United Facility/Professional Facility Modifier Low / Median / High Price $2.88 / $138.04 / $316.23	Facility		$2.88	$138.04	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $229.09 / $398.11	Professional		$199.53	$229.09	$398.11