Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $660.69 / $3,090.30	Facility		$407.38	$660.69	$3,090.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $389.05 / $478.63	Professional		$380.19	$389.05	$478.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $380.19 / $741.31	Facility		$363.08	$380.19	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $467.74	Professional		$380.19	$380.19	$467.74
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 $380.19 / $436.52 / $707.95	Facility		$380.19	$436.52	$707.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $426.58 / $1,023.29	Facility		$323.59	$426.58	$1,023.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $398.11 / $436.52	Professional		$371.54	$398.11	$436.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $446.68 / $1,071.52	Facility		$371.54	$446.68	$1,071.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Professional		$380.19	$380.19	$380.19
United Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Facility		$380.19	$380.19	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $446.68	Professional		$380.19	$380.19	$446.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $501.19	Professional		$371.54	$371.54	$501.19