Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $601.62 / $637.90 / $948.42	Professional		$601.62	$637.90	$948.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $105.38 / $6,352.54 / $6,352.54	Facility		$105.38	$6,352.54	$6,352.54
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $99.90 / $768.71 / $1,263.68	Professional		$99.90	$768.71	$1,263.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $344.45 / $344.45 / $344.45	Facility		$344.45	$344.45	$344.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.06 / $292.77 / $344.45	Professional		$105.06	$292.77	$344.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $120.35 / $120.35	Professional		$60.00	$120.35	$120.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,973.95 / $2,370.96 / $2,404.63	Facility		$1,973.95	$2,370.96	$2,404.63
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,973.95 / $2,370.96 / $2,404.63	Professional		$1,973.95	$2,370.96	$2,404.63
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $105.38 / $105.38 / $105.38	Facility		$105.38	$105.38	$105.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.90 / $1,140.04 / $2,119.17	Professional		$99.90	$1,140.04	$2,119.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $81.27 / $81.27 / $98.95	Professional		$81.27	$81.27	$98.95
United Facility/Professional Professional Modifier Low / Median / High Price $476.66 / $595.91 / $993.19	Professional		$476.66	$595.91	$993.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $735.65 / $735.65 / $735.65	Professional		$735.65	$735.65	$735.65