Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $519.54 / $862.25 / $862.25	Facility		$519.54	$862.25	$862.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $360.00 / $478.11 / $931.94	Professional		$360.00	$478.11	$931.94
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,272.93 / $2,436.81 / $4,714.28	Facility		$1,272.93	$2,436.81	$4,714.28
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $202.22 / $846.24 / $1,654.20	Professional		$202.22	$846.24	$1,654.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $852.06 / $1,677.50 / $2,163.84	Facility		$852.06	$1,677.50	$2,163.84
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 $1,299.00 / $2,081.00 / $2,880.61	Facility		$1,299.00	$2,081.00	$2,880.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $561.54 / $561.54 / $561.54	Professional		$561.54	$561.54	$561.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,580.16 / $2,436.81 / $4,634.07	Facility		$1,580.16	$2,436.81	$4,634.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $400.00 / $400.00	Professional		$400.00	$400.00	$400.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $900.00 / $900.00 / $1,165.50	Professional		$900.00	$900.00	$1,165.50