Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $88.43 / $208.08	Facility		$88.43	$88.43	$208.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.35 / $88.43 / $88.43	Professional		$86.35	$88.43	$88.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $86.35 / $88.43 / $437.90	Facility		$86.35	$88.43	$437.90
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $88.43 / $104.04	Professional		$88.43	$88.43	$104.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $88.43 / $367.60	Facility		$88.43	$88.43	$367.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Professional		$88.43	$88.43	$88.43
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 $86.35 / $86.35 / $88.43	Facility		$86.35	$86.35	$88.43
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.11 / $93.64 / $104.04	Professional		$80.11	$93.64	$104.04
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $88.43 / $99.18	Facility		$88.43	$88.43	$99.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Professional		$88.43	$88.43	$88.43
United Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $86.70 / $86.70	Professional		$86.70	$86.70	$86.70