Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.53 / $57.53 / $135.36	Facility		$57.53	$57.53	$135.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.17 / $57.53 / $57.53	Professional		$56.17	$57.53	$57.53
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $57.53 / $70.56 / $134.72	Facility		$57.53	$70.56	$134.72
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $57.53 / $57.53 / $67.68	Professional		$57.53	$57.53	$67.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.53 / $57.53 / $115.06	Facility		$57.53	$57.53	$115.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.53 / $57.53 / $57.53	Professional		$57.53	$57.53	$57.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $58.81 / $79,999.20 / $79,999.20	Facility		$58.81	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.01 / $58.83 / $134.72	Facility		$50.01	$58.83	$134.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.11 / $60.91 / $67.68	Professional		$52.11	$60.91	$67.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $57.53 / $63.28 / $117.62	Facility		$57.53	$63.28	$117.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $57.53 / $57.53 / $57.53	Professional		$57.53	$57.53	$57.53
United Facility/Professional Professional Modifier Low / Median / High Price $56.40 / $56.40 / $67.68	Professional		$56.40	$56.40	$67.68