Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $177.00 / $177.00 / $177.00	Facility		$177.00	$177.00	$177.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.25 / $114.38 / $229.03	Facility		$68.25	$114.38	$229.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $148.50 / $200.00	Facility		$35.00	$148.50	$200.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.00 / $177.00 / $177.00	Facility		$177.00	$177.00	$177.00