Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $615.26 / $615.26 / $615.26	Facility		$615.26	$615.26	$615.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $579.07 / $615.26 / $615.26	Professional		$579.07	$615.26	$615.26
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $600.79 / $723.84 / $2,714.40	Facility		$600.79	$723.84	$2,714.40
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $615.26 / $2,750.59 / $3,257.28	Professional		$615.26	$2,750.59	$3,257.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $615.26 / $615.26 / $1,230.52	Facility		$615.26	$615.26	$1,230.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $615.26 / $615.26 / $615.26	Professional		$615.26	$615.26	$615.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$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 $600.79 / $600.79 / $615.26	Facility		$600.79	$600.79	$615.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $557.36 / $615.26 / $651.46	Professional		$557.36	$615.26	$651.46
United Facility/Professional Professional Modifier Low / Median / High Price $723.84 / $723.84 / $868.61	Professional		$723.84	$723.84	$868.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $633.36 / $633.36 / $633.36	Professional		$633.36	$633.36	$633.36