Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Facility Modifier Low / Median / High Price $144.99 / $217.16 / $412.00	Facility		$144.99	$217.16	$412.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $177.00 / $177.00 / $314.68	Facility		$177.00	$177.00	$314.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.25 / $123.98 / $229.03	Facility		$68.25	$123.98	$229.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $174.00 / $237.00	Facility		$35.00	$174.00	$237.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.00 / $177.00 / $314.68	Facility		$177.00	$177.00	$314.68