Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $1,122.02 / $2,454.71	Facility		$234.42	$1,122.02	$2,454.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $194.98 / $295.12	Professional		$165.96	$194.98	$295.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $549.54 / $630.96	Facility		$257.04	$549.54	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $281.84 / $354.81	Professional		$281.84	$281.84	$354.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $269.15 / $436.52	Facility		$223.87	$269.15	$436.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $436.52 / $741.31	Facility		$245.47	$436.52	$741.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $295.12	Professional		$223.87	$223.87	$295.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $371.54 / $676.08	Facility		$257.04	$371.54	$676.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $223.87 / $245.47	Professional		$186.21	$223.87	$245.47
United Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $295.12 / $295.12	Facility		$245.47	$295.12	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $245.47	Professional		$104.71	$104.71	$245.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $446.68	Professional		$112.20	$112.20	$446.68