Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $127.50 / $300.00	Facility		$127.50	$127.50	$300.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.50 / $127.50 / $127.50	Professional		$124.50	$127.50	$127.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $124.64 / $198.12 / $422.66	Facility		$124.64	$198.12	$422.66
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $150.00	Professional		$127.50	$127.50	$150.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $127.50 / $319.62	Facility		$127.50	$127.50	$319.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Professional		$127.50	$127.50	$127.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $236.81 / $79,999.20 / $79,999.20	Facility		$236.81	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $119.12 / $211.77 / $370.60	Facility		$119.12	$211.77	$370.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.50 / $135.00 / $150.00	Professional		$115.50	$135.00	$150.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $124.64 / $158.50 / $422.66	Facility		$124.64	$158.50	$422.66
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Professional		$127.50	$127.50	$127.50
United Facility/Professional Professional Modifier Low / Median / High Price $125.00 / $125.00 / $125.00	Professional		$125.00	$125.00	$125.00