Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.95 / $53.95 / $126.94	Facility		$53.95	$53.95	$126.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.68 / $53.95 / $53.95	Professional		$52.68	$53.95	$53.95
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $187.83 / $333.31 / $671.20	Facility		$187.83	$333.31	$671.20
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $46.40 / $57.12 / $78.95	Professional		$46.40	$57.12	$78.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.95 / $53.95 / $191.44	Facility		$53.95	$53.95	$191.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.95 / $53.95 / $53.95	Professional		$53.95	$53.95	$53.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $162.00 / $79,999.20 / $79,999.20	Facility		$162.00	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $52.68 / $52.68 / $53.95	Facility		$52.68	$52.68	$53.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.87 / $57.12 / $63.47	Professional		$48.87	$57.12	$63.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $221.46 / $311.06 / $587.15	Facility		$221.46	$311.06	$587.15
United Facility/Professional Professional Modifier Low / Median / High Price $52.89 / $52.89 / $52.89	Professional		$52.89	$52.89	$52.89