Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $795.51 / $795.51 / $795.51	Facility		$795.51	$795.51	$795.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $479.99 / $795.51 / $940.54	Professional		$479.99	$795.51	$940.54
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $837.48 / $1,344.99 / $2,396.89	Facility		$837.48	$1,344.99	$2,396.89
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $73.59 / $73.59 / $1,329.50	Professional		$73.59	$73.59	$1,329.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $293.45 / $293.45 / $293.45	Professional		$293.45	$293.45	$293.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.13 / $109.13 / $133.38	Professional		$109.13	$109.13	$133.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $758.06 / $762.43 / $1,213.23	Facility		$758.06	$762.43	$1,213.23
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $758.06 / $762.43 / $1,233.55	Professional		$758.06	$762.43	$1,233.55
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $82.66 / $1,052.45 / $1,742.06	Facility		$82.66	$1,052.45	$1,742.06
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.59 / $166.59 / $735.98	Professional		$73.59	$166.59	$735.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $907.91 / $1,162.13 / $2,178.98	Facility		$907.91	$1,162.13	$2,178.98
United Facility/Professional Professional Modifier Low / Median / High Price $862.86 / $1,699.19 / $2,318.34	Professional		$862.86	$1,699.19	$2,318.34