Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,224.78 / $1,224.78 / $1,224.78	Facility		$1,224.78	$1,224.78	$1,224.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,198.80 / $1,224.78 / $2,003.04	Professional		$1,198.80	$1,224.78	$2,003.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $11,834.20 / $11,834.20	Facility		$100.00	$11,834.20	$11,834.20
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,120.40 / $1,526.79 / $2,387.40	Professional		$1,120.40	$1,526.79	$2,387.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.19 / $144.19 / $211.75	Facility		$144.19	$144.19	$211.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.56 / $144.19 / $211.75	Professional		$122.56	$144.19	$211.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $1,687.32 / $2,062.28	Professional		$75.00	$1,687.32	$2,062.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,121.35 / $3,677.30 / $4,416.91	Facility		$2,121.35	$3,677.30	$4,416.91
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,121.35 / $2,584.19 / $2,584.19	Professional		$2,121.35	$2,584.19	$2,584.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $215.00 / $215.00 / $215.00	Facility		$215.00	$215.00	$215.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $433.55 / $2,030.06 / $4,335.47	Professional		$433.55	$2,030.06	$4,335.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $165.14 / $165.14 / $201.07	Professional		$165.14	$165.14	$201.07
United Facility/Professional Professional Modifier Low / Median / High Price $835.19 / $856.32 / $1,391.98	Professional		$835.19	$856.32	$1,391.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3,755.50 / $3,755.50 / $3,755.50	Professional		$3,755.50	$3,755.50	$3,755.50