Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $870.96 / $1,047.13	Facility		$512.86	$870.96	$1,047.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $512.86 / $616.60	Professional		$501.19	$512.86	$616.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $467.74 / $933.25	Facility		$467.74	$467.74	$933.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $501.19 / $616.60	Professional		$501.19	$501.19	$616.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $537.03 / $831.76	Facility		$478.63	$537.03	$831.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $537.03 / $1,230.27	Facility		$398.11	$537.03	$1,230.27
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $512.86 / $549.54	Professional		$467.74	$512.86	$549.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $549.54 / $1,445.44	Facility		$354.81	$549.54	$1,445.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Professional		$501.19	$501.19	$501.19
United Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Professional		$501.19	$501.19	$501.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $501.19 / $645.65	Professional		$501.19	$501.19	$645.65