Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.75 / $63.75 / $150.00	Facility		$63.75	$63.75	$150.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.25 / $63.75 / $63.75	Professional		$62.25	$63.75	$63.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $164.96 / $250.61 / $484.50	Facility		$164.96	$250.61	$484.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $58.65 / $111.60 / $183.95	Professional		$58.65	$111.60	$183.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.75 / $127.50 / $416.06	Facility		$63.75	$127.50	$416.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.75 / $63.75 / $63.75	Professional		$63.75	$63.75	$63.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $392.05 / $79,999.20 / $79,999.20	Facility		$392.05	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.65 / $249.56 / $436.73	Facility		$58.65	$249.56	$436.73
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.13 / $62.10 / $69.00	Professional		$53.13	$62.10	$69.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $167.07 / $196.86 / $484.50	Facility		$167.07	$196.86	$484.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $183.95 / $183.95 / $183.95	Professional		$183.95	$183.95	$183.95
United Facility/Professional Professional Modifier Low / Median / High Price $62.50 / $62.50 / $62.50	Professional		$62.50	$62.50	$62.50