Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $255.00 / $255.00 / $600.00	Facility		$255.00	$255.00	$600.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.00 / $255.00 / $255.00	Professional		$240.00	$255.00	$255.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $239.25 / $382.80 / $1,139.65	Facility		$239.25	$382.80	$1,139.65
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $240.00 / $255.00 / $293.25	Professional		$240.00	$255.00	$293.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $255.00 / $255.00 / $869.20	Facility		$255.00	$255.00	$869.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.00 / $255.00 / $255.00	Professional		$255.00	$255.00	$255.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $225.00 / $275.00 / $275.00	Professional		$225.00	$275.00	$275.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $319.47 / $79,999.20 / $79,999.20	Facility		$319.47	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $239.94 / $307.12 / $580.66	Facility		$239.94	$307.12	$580.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $231.00 / $255.00 / $300.00	Professional		$231.00	$255.00	$300.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $239.25 / $287.10 / $532.69	Facility		$239.25	$287.10	$532.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $255.00 / $255.00 / $255.00	Professional		$255.00	$255.00	$255.00
United Facility/Professional Professional Modifier Low / Median / High Price $212.50 / $250.00 / $250.00	Professional		$212.50	$250.00	$250.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $250.00 / $250.00	Professional		$250.00	$250.00	$250.00