Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $912.01 / $1,258.93	Facility		$575.44	$912.01	$1,258.93
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 $501.19 / $501.19 / $1,071.52	Facility		$501.19	$501.19	$1,071.52
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 $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $660.69 / $1,000.00	Facility		$524.81	$660.69	$1,000.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $812.83 / $1,380.38	Facility		$478.63	$812.83	$1,380.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $794.33 / $794.33	Professional		$512.86	$794.33	$794.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $645.65 / $1,621.81	Facility		$524.81	$645.65	$1,621.81
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 / $691.83	Professional		$524.81	$524.81	$691.83