Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $676.08 / $1,122.02	Facility		$478.63	$676.08	$1,122.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $467.74 / $501.19	Professional		$446.68	$467.74	$501.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $478.63 / $954.99	Facility		$10.23	$478.63	$954.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Professional		$478.63	$478.63	$478.63
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 $5.50 / $426.58 / $602.56	Facility		$5.50	$426.58	$602.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3.80 / $489.78 / $1,380.38	Facility		$3.80	$489.78	$1,380.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6.17 / $9.33 / $218.78	Facility		$6.17	$9.33	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Professional		$467.74	$467.74	$467.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Professional		$467.74	$467.74	$467.74