Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $299.83 / $497.61 / $497.61	Facility		$299.83	$497.61	$497.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $299.83 / $332.17 / $381.65	Professional		$299.83	$332.17	$381.65
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $119.37 / $168.65 / $297.08	Facility		$119.37	$168.65	$297.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $17.30 / $108.00 / $198.50	Professional		$17.30	$108.00	$198.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $114.47 / $250.16	Facility		$53.70	$114.47	$250.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.45 / $136.81 / $152.18	Professional		$109.45	$136.81	$152.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $50.00	Professional		$50.00	$50.00	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $82.00 / $131.00 / $238.03	Facility		$82.00	$131.00	$238.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $117.30 / $156.49 / $292.02	Facility		$117.30	$156.49	$292.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $108.00 / $108.00 / $139.86	Professional		$108.00	$108.00	$139.86