Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.43 / $20.43 / $48.06	Facility		$20.43	$20.43	$48.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.43 / $20.43 / $20.43	Professional		$20.43	$20.43	$20.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $18.25 / $27.50 / $56.82	Facility		$18.25	$27.50	$56.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.43 / $40.86 / $61.12	Facility		$20.43	$40.86	$61.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.43 / $20.43 / $20.43	Professional		$20.43	$20.43	$20.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $23.12 / $79,999.20 / $79,999.20	Facility		$23.12	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $16.23 / $30.29 / $51.10	Facility		$16.23	$30.29	$51.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $18.13 / $22.91 / $40.81	Facility		$18.13	$22.91	$40.81