Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $7,244.36	Facility		$3,090.30	$3,090.30	$7,244.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $3,019.95 / $3,311.31	Professional		$2,884.03	$3,019.95	$3,311.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $6,760.83	Facility		$3,090.30	$3,090.30	$6,760.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $3,090.30	Professional		$3,090.30	$3,090.30	$3,090.30
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 $1,862.09 / $2,238.72 / $2,290.87	Facility		$1,862.09	$2,238.72	$2,290.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $3,090.30 / $7,762.47	Facility		$2,344.23	$3,090.30	$7,762.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,818.38 / $3,090.30 / $3,235.94	Professional		$2,818.38	$3,090.30	$3,235.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $3,235.94 / $7,762.47	Facility		$2,691.53	$3,235.94	$7,762.47
United Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $2,884.03	Facility		$2,884.03	$2,884.03	$2,884.03
United Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $3,019.95 / $3,019.95	Professional		$3,019.95	$3,019.95	$3,019.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $3,019.95 / $3,019.95	Professional		$3,019.95	$3,019.95	$3,019.95