Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $520.71 / $520.71 / $1,225.20	Facility		$520.71	$520.71	$1,225.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $508.46 / $520.71 / $520.71	Professional		$508.46	$520.71	$520.71
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $520.71 / $624.85 / $1,303.77	Facility		$520.71	$624.85	$1,303.77
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $520.71 / $520.71 / $612.60	Professional		$520.71	$520.71	$612.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $520.71 / $1,041.42 / $2,082.84	Facility		$520.71	$1,041.42	$2,082.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $520.71 / $520.71 / $520.71	Professional		$520.71	$520.71	$520.71
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 $811.70 / $79,999.20 / $79,999.20	Facility		$811.70	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $484.87 / $861.99 / $1,508.49	Facility		$484.87	$861.99	$1,508.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $471.70 / $551.34 / $612.60	Professional		$471.70	$551.34	$612.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $520.71 / $572.78 / $1,077.11	Facility		$520.71	$572.78	$1,077.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $520.71 / $520.71 / $520.71	Professional		$520.71	$520.71	$520.71
United Facility/Professional Professional Modifier Low / Median / High Price $510.50 / $510.50 / $612.60	Professional		$510.50	$510.50	$612.60