Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $142.00 / $142.00 / $142.00	Facility		$142.00	$142.00	$142.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $75.00 / $90.00	Facility		$75.00	$75.00	$90.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $35.00 / $35.00	Facility		$35.00	$35.00	$35.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $142.00 / $142.00 / $142.00	Facility		$142.00	$142.00	$142.00