Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,047.13 / $1,949.84	Professional		$891.25	$1,047.13	$1,949.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Facility		$398.11	$398.11	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $338.84 / $398.11	Professional		$154.88	$338.84	$398.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $208.93 / $213.80	Professional		$60.26	$208.93	$213.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $3,548.13 / $3,548.13	Facility		$2,951.21	$3,548.13	$3,548.13
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $3,548.13 / $3,548.13	Professional		$2,951.21	$3,548.13	$3,548.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $186.21 / $1,862.09	Facility		$173.78	$186.21	$1,862.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $239.88 / $1,862.09	Professional		$173.78	$239.88	$1,862.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $173.78 / $173.78	Professional		$141.25	$173.78	$173.78
United Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $812.83 / $1,412.54	Facility		$89.13	$812.83	$1,412.54
United Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $891.25 / $1,479.11	Professional		$707.95	$891.25	$1,479.11