Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.39 / $275.39 / $367.65	Facility		$275.39	$275.39	$367.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.39 / $275.39 / $313.95	Professional		$275.39	$275.39	$313.95
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $0.02 / $0.02 / $291.60	Facility		$0.02	$0.02	$291.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $291.60 / $291.60 / $340.20	Professional		$291.60	$291.60	$340.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $302.39 / $302.39 / $604.79	Facility		$302.39	$302.39	$604.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.39 / $302.39 / $302.39	Professional		$302.39	$302.39	$302.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $2.67 / $6.67 / $50.00	Professional		$2.67	$6.67	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $259.20 / $259.20 / $324.00	Facility		$259.20	$259.20	$324.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $0.02 / $0.03 / $324.00	Facility		$0.02	$0.03	$324.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $262.44 / $307.80 / $340.20	Professional		$262.44	$307.80	$340.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $0.02 / $0.02 / $0.04	Facility		$0.02	$0.02	$0.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $291.60 / $291.60 / $291.60	Professional		$291.60	$291.60	$291.60
United Facility/Professional Facility Modifier Low / Median / High Price $0.02 / $0.02 / $0.02	Facility		$0.02	$0.02	$0.02
United Facility/Professional Professional Modifier Low / Median / High Price $247.34 / $279.49 / $324.00	Professional		$247.34	$279.49	$324.00