Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $1,778.28 / $3,890.45	Facility		$363.08	$1,778.28	$3,890.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $309.03 / $467.74	Professional		$263.03	$309.03	$467.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $870.96 / $1,000.00	Facility		$407.38	$870.96	$1,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $446.68 / $562.34	Professional		$446.68	$446.68	$562.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $64.57	Professional		$44.67	$50.12	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $588.84	Facility		$389.05	$389.05	$588.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $676.08 / $1,174.90	Facility		$389.05	$676.08	$1,174.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $467.74	Professional		$354.81	$354.81	$467.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $588.84 / $1,071.52	Facility		$407.38	$588.84	$1,071.52
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $354.81 / $389.05	Professional		$295.12	$354.81	$389.05
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $467.74 / $467.74	Facility		$389.05	$467.74	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $389.05	Professional		$165.96	$165.96	$389.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $707.95	Professional		$177.83	$177.83	$707.95