Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $600.00 / $600.00 / $600.00	Facility		$600.00	$600.00	$600.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $600.00 / $600.00 / $600.00	Professional		$600.00	$600.00	$600.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $81.51 / $100.00 / $3,508.51	Facility		$81.51	$100.00	$3,508.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $263.00 / $1,147.50 / $2,000.00	Professional		$263.00	$1,147.50	$2,000.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,150.00 / $1,150.00 / $1,200.00	Facility		$1,150.00	$1,150.00	$1,200.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $839.50 / $977.50 / $1,150.00	Professional		$839.50	$977.50	$1,150.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $455.78 / $872.75 / $1,570.95	Professional		$455.78	$872.75	$1,570.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,614.00 / $1,614.00 / $1,614.00	Facility		$1,614.00	$1,614.00	$1,614.00
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,614.00 / $1,614.00 / $1,614.00	Professional		$1,614.00	$1,614.00	$1,614.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,014.22 / $3,014.22 / $3,014.22	Professional		$3,014.22	$3,014.22	$3,014.22
United Facility/Professional Professional Modifier Low / Median / High Price $109.02 / $466.20 / $466.20	Professional		$109.02	$466.20	$466.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,147.50 / $1,147.50 / $1,147.50	Professional		$1,147.50	$1,147.50	$1,147.50