Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.38 / $101.60 / $133.76	Facility		$58.38	$101.60	$133.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.08 / $58.38 / $64.33	Professional		$53.08	$58.38	$64.33
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $53.08 / $79.62 / $164.55	Facility		$53.08	$79.62	$164.55
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $47.49 / $53.08 / $87.58	Professional		$47.49	$53.08	$87.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.49 / $94.98 / $218.16	Facility		$47.49	$94.98	$218.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.49 / $47.49 / $47.49	Professional		$47.49	$47.49	$47.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $53.08 / $84.93 / $79,999.20	Facility		$53.08	$84.93	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $46.37 / $84.92 / $148.62	Facility		$46.37	$84.92	$148.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.02 / $50.28 / $55.87	Professional		$43.02	$50.28	$55.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $53.08 / $66.34 / $136.25	Facility		$53.08	$66.34	$136.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $53.08 / $53.08 / $53.08	Professional		$53.08	$53.08	$53.08
United Facility/Professional Professional Modifier Low / Median / High Price $53.08 / $53.08 / $53.08	Professional		$53.08	$53.08	$53.08