Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.60 / $58.60 / $58.60	Facility		$58.60	$58.60	$58.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.15 / $58.60 / $58.60	Professional		$55.15	$58.60	$58.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $57.22 / $85.00 / $258.52	Facility		$57.22	$85.00	$258.52
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $58.60 / $261.97 / $310.23	Professional		$58.60	$261.97	$310.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.60 / $58.60 / $117.20	Facility		$58.60	$58.60	$117.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.60 / $58.60 / $58.60	Professional		$58.60	$58.60	$58.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Professional		$50.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.22 / $57.22 / $58.60	Facility		$57.22	$57.22	$58.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.08 / $58.60 / $62.05	Professional		$53.08	$58.60	$62.05
United Facility/Professional Professional Modifier Low / Median / High Price $68.94 / $68.94 / $82.73	Professional		$68.94	$68.94	$82.73
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $58.60 / $58.60 / $58.60	Professional		$58.60	$58.60	$58.60