Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $676.80 / $2,625.12 / $4,723.20	Facility		$676.80	$2,625.12	$4,723.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $381.60 / $676.80 / $676.80	Professional		$381.60	$676.80	$676.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $756.00 / $1,181.52 / $3,420.00	Facility		$756.00	$1,181.52	$3,420.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $228.90 / $648.00 / $1,022.40	Professional		$228.90	$648.00	$1,022.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $748.80 / $1,474.20 / $1,859.13	Facility		$748.80	$1,474.20	$1,859.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $827.24 / $827.24 / $1,034.05	Professional		$827.24	$827.24	$1,034.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $720.00 / $720.00 / $1,008.00	Facility		$720.00	$720.00	$1,008.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $720.00 / $1,080.00 / $1,980.00	Facility		$720.00	$1,080.00	$1,980.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $612.00 / $756.00 / $1,022.40	Professional		$612.00	$756.00	$1,022.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $756.00 / $1,181.52 / $1,980.00	Facility		$756.00	$1,181.52	$1,980.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $540.00 / $720.00 / $1,942.81	Professional		$540.00	$720.00	$1,942.81
United Facility/Professional Professional Modifier Low / Median / High Price $302.39 / $302.39 / $720.00	Professional		$302.39	$302.39	$720.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $324.00 / $324.00 / $372.96	Professional		$324.00	$324.00	$372.96