Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,412.54 / $4,365.16	Facility		$812.83	$1,412.54	$4,365.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $794.33 / $1,348.96	Professional		$776.25	$794.33	$1,348.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $3,090.30	Facility		$812.83	$812.83	$3,090.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Professional		$812.83	$812.83	$812.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $794.33 / $2,137.96	Professional		$50.12	$794.33	$2,137.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $2,089.30 / $2,089.30	Facility		$1,949.84	$2,089.30	$2,089.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,230.27 / $3,019.95	Facility		$812.83	$1,230.27	$3,019.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $812.83 / $870.96	Professional		$741.31	$812.83	$870.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,288.25 / $3,311.31	Facility		$1,071.52	$1,288.25	$3,311.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Professional		$812.83	$812.83	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Professional		$794.33	$794.33	$794.33