Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $870.96 / $1,096.48	Facility		$501.19	$870.96	$1,096.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $562.34 / $1,023.29	Professional		$524.81	$562.34	$1,023.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $1,047.13	Facility		$489.78	$489.78	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $645.65	Professional		$524.81	$524.81	$645.65
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 $549.54 / $676.08 / $1,023.29	Facility		$549.54	$676.08	$1,023.29
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $630.96 / $1,548.82	Facility		$269.15	$630.96	$1,548.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $630.96 / $630.96	Professional		$524.81	$630.96	$630.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $676.08 / $1,584.89	Facility		$549.54	$676.08	$1,584.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $524.81	Professional		$524.81	$524.81	$524.81
United Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $524.81	Facility		$524.81	$524.81	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $524.81	Professional		$524.81	$524.81	$524.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $676.08	Professional		$524.81	$524.81	$676.08