Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.43 / $413.49 / $513.87	Professional		$316.43	$413.49	$513.87
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $741.00 / $3,288.67 / $3,288.67	Facility		$741.00	$3,288.67	$3,288.67
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $415.80 / $416.50 / $723.00	Professional		$415.80	$416.50	$723.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.00 / $128.00 / $128.00	Facility		$128.00	$128.00	$128.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.44 / $128.00 / $242.55	Professional		$22.44	$128.00	$242.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $45.00 / $50.00	Professional		$40.00	$45.00	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,021.90 / $1,227.43 / $1,244.85	Facility		$1,021.90	$1,227.43	$1,244.85
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,021.90 / $1,227.43 / $1,244.85	Professional		$1,021.90	$1,227.43	$1,244.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Professional		$85.00	$85.00	$85.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $927.72 / $927.72 / $927.72	Facility		$927.72	$927.72	$927.72
United Facility/Professional Professional Modifier Low / Median / High Price $399.14 / $402.32 / $670.54	Professional		$399.14	$402.32	$670.54