Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.25 / $230.96 / $304.20	Professional		$135.25	$230.96	$304.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $864.68 / $1,288.56	Facility		$100.00	$864.68	$1,288.56
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $50.25 / $222.00 / $472.32	Professional		$50.25	$222.00	$472.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $193.40 / $193.40 / $258.98	Facility		$193.40	$193.40	$258.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.39 / $193.40 / $258.98	Professional		$164.39	$193.40	$258.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.20 / $50.20 / $442.22	Professional		$50.20	$50.20	$442.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $400.40 / $480.93 / $590.76	Facility		$400.40	$480.93	$590.76
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $400.40 / $480.93 / $487.76	Professional		$400.40	$480.93	$487.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.93 / $33.93 / $33.93	Facility		$33.93	$33.93	$33.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.47 / $224.66 / $387.98	Professional		$22.47	$224.66	$387.98
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $50.25 / $50.25 / $61.18	Professional		$50.25	$50.25	$61.18
United Facility/Professional Professional Modifier Low / Median / High Price $17.10 / $28.50 / $299.22	Professional		$17.10	$28.50	$299.22
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $222.00 / $222.00 / $380.16	Professional		$222.00	$222.00	$380.16