Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $512.86 / $891.25	Professional		$478.63	$512.86	$891.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Facility		$616.60	$616.60	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $524.81 / $616.60	Professional		$69.18	$524.81	$616.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,318.26 / $1,380.38	Facility		$1,096.48	$1,318.26	$1,380.38
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,318.26 / $1,318.26	Professional		$1,096.48	$1,318.26	$1,318.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $91.20 / $912.01	Facility		$66.07	$91.20	$912.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $93.33 / $851.14	Professional		$66.07	$93.33	$851.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $144.54 / $144.54	Professional		$117.49	$144.54	$144.54
United Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $323.59 / $588.84	Facility		$42.66	$323.59	$588.84
United Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $416.87 / $588.84	Professional		$354.81	$416.87	$588.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Professional		$616.60	$616.60	$616.60