Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.80 / $44.80 / $125.60	Professional		$16.80	$44.80	$125.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $214.45	Facility		$100.00	$100.00	$214.45
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $214.45 / $214.45 / $64,999.35	Professional		$214.45	$214.45	$64,999.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.05 / $25.05 / $25.05	Professional		$25.05	$25.05	$25.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $85.00	Professional		$45.00	$50.00	$85.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,000.00 / $4,000.00 / $79,999.20	Facility		$4,000.00	$4,000.00	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,000.00 / $4,000.00 / $4,000.00	Professional		$4,000.00	$4,000.00	$4,000.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $430.00 / $430.00 / $430.00	Professional		$430.00	$430.00	$430.00