Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $660.69	Facility		$660.69	$660.69	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $741.31 / $1,230.27	Professional		$630.96	$741.31	$1,230.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $776.25 / $776.25	Facility		$776.25	$776.25	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $660.69 / $776.25	Professional		$107.15	$660.69	$776.25
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 $1,584.89 / $2,089.30 / $2,511.89	Facility		$1,584.89	$2,089.30	$2,511.89
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,905.46 / $1,905.46	Professional		$1,584.89	$1,905.46	$1,905.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $117.49 / $1,174.90	Facility		$102.33	$117.49	$1,174.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $141.25 / $1,174.90	Professional		$102.33	$141.25	$1,174.90
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 $63.10 / $575.44 / $977.24	Facility		$63.10	$575.44	$977.24
United Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $616.60 / $1,047.13	Professional		$575.44	$616.60	$1,047.13