Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $395.45 / $516.76 / $642.20	Professional		$395.45	$516.76	$642.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,159.41 / $4,109.93 / $4,109.93	Facility		$1,159.41	$4,109.93	$4,109.93
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $441.10 / $611.10 / $897.65	Professional		$441.10	$611.10	$897.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $200.00 / $200.00	Facility		$200.00	$200.00	$200.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.93 / $179.00 / $200.00	Professional		$26.93	$179.00	$200.00
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 $1,277.09 / $1,533.96 / $1,555.74	Facility		$1,277.09	$1,533.96	$1,555.74
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,277.09 / $1,533.96 / $1,555.74	Professional		$1,277.09	$1,533.96	$1,555.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,159.41 / $1,159.41 / $1,159.41	Facility		$1,159.41	$1,159.41	$1,159.41
United Facility/Professional Professional Modifier Low / Median / High Price $474.21 / $502.80 / $838.00	Professional		$474.21	$502.80	$838.00