Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Facility		$446.68	$446.68	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $524.81 / $870.96	Professional		$398.11	$524.81	$870.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Facility		$549.54	$549.54	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $467.74 / $549.54	Professional		$66.07	$467.74	$549.54
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 $1,148.15 / $1,230.27 / $1,412.54	Facility		$1,148.15	$1,230.27	$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 / $79.43 / $794.33	Facility		$60.26	$79.43	$794.33
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 $97.72 / $120.23 / $120.23	Professional		$97.72	$120.23	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $436.52 / $758.58	Facility		$42.66	$436.52	$758.58
United Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $537.03 / $933.25	Professional		$478.63	$537.03	$933.25