Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $961.74 / $961.74 / $961.74	Facility		$961.74	$961.74	$961.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $787.48 / $961.74 / $1,448.01	Professional		$787.48	$961.74	$1,448.01
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $168.80 / $9,804.04 / $9,804.04	Facility		$168.80	$9,804.04	$9,804.04
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $200.04 / $1,256.81 / $2,204.37	Professional		$200.04	$1,256.81	$2,204.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,122.47 / $1,122.47 / $1,459.20	Facility		$1,122.47	$1,122.47	$1,459.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $341.57 / $954.10 / $1,459.20	Professional		$341.57	$954.10	$1,459.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.07 / $106.42 / $1,050.47	Professional		$87.07	$106.42	$1,050.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,243.44 / $3,046.45 / $3,659.17	Facility		$2,243.44	$3,046.45	$3,659.17
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,243.44 / $2,732.93 / $2,732.93	Professional		$2,243.44	$2,732.93	$2,732.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $168.80 / $168.80 / $168.80	Facility		$168.80	$168.80	$168.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $200.04 / $1,687.32 / $2,000.43	Professional		$200.04	$1,687.32	$2,000.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $162.55 / $162.55 / $197.92	Professional		$162.55	$162.55	$197.92
United Facility/Professional Professional Modifier Low / Median / High Price $810.16 / $883.25 / $1,472.09	Professional		$810.16	$883.25	$1,472.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,441.52 / $1,441.52 / $1,441.52	Professional		$1,441.52	$1,441.52	$1,441.52