Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.62 / $71.76 / $116.76	Facility		$49.62	$71.76	$116.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.46 / $49.62 / $85.62	Professional		$48.46	$49.62	$85.62
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $48.46 / $49.62 / $218.93	Facility		$48.46	$49.62	$218.93
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $49.62 / $49.62 / $58.38	Professional		$49.62	$49.62	$58.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $49.62 / $49.62 / $157.80	Facility		$49.62	$49.62	$157.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.62 / $49.62 / $49.62	Professional		$49.62	$49.62	$49.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $48.46 / $48.46 / $49.62	Facility		$48.46	$48.46	$49.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.95 / $52.54 / $58.38	Professional		$44.95	$52.54	$58.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $49.62 / $49.62 / $49.62	Facility		$49.62	$49.62	$49.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $49.62 / $49.62 / $49.62	Professional		$49.62	$49.62	$49.62
United Facility/Professional Professional Modifier Low / Median / High Price $48.65 / $48.65 / $48.65	Professional		$48.65	$48.65	$48.65