Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.23 / $202.98 / $211.10	Facility		$113.23	$202.98	$211.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $113.23 / $122.80	Professional		$102.94	$113.23	$122.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $102.94 / $151.41 / $697.75	Facility		$102.94	$151.41	$697.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $122.53 / $181.50	Professional		$102.94	$122.53	$181.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.11 / $97.11 / $221.36	Facility		$97.11	$97.11	$221.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $126.24	Professional		$102.94	$102.94	$126.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $50.00	Professional		$50.00	$50.00	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $101.48 / $116.53 / $304.47	Facility		$101.48	$116.53	$304.47
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $133.19 / $150.63 / $150.63	Facility		$133.19	$150.63	$150.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.81 / $122.53 / $181.50	Professional		$110.81	$122.53	$181.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $102.94 / $151.41 / $260.74	Facility		$102.94	$151.41	$260.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $102.94	Professional		$102.94	$102.94	$102.94
United Facility/Professional Facility Modifier Low / Median / High Price $102.93 / $102.93 / $102.93	Facility		$102.93	$102.93	$102.93
United Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $102.94	Professional		$102.94	$102.94	$102.94