Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $562.34 / $1,000.00	Professional		$478.63	$562.34	$1,000.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Facility		$426.58	$426.58	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $363.08 / $426.58	Professional		$85.11	$363.08	$426.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $112.20 / $114.82	Professional		$60.26	$112.20	$114.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,905.46 / $1,905.46	Facility		$1,584.89	$1,905.46	$1,905.46
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 $93.33 / $100.00 / $1,000.00	Facility		$93.33	$100.00	$1,000.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $131.83 / $1,000.00	Professional		$93.33	$131.83	$1,000.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $93.33 / $93.33	Professional		$75.86	$93.33	$93.33
United Facility/Professional Facility Modifier Low / Median / High Price $5.75 / $331.13 / $758.58	Facility		$5.75	$331.13	$758.58
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $478.63 / $794.33	Professional		$380.19	$478.63	$794.33