Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $483.94 / $2,064.40 / $13,750.00	Facility		$483.94	$2,064.40	$13,750.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $4,000.00 / $6,313.44	Facility		$55.00	$4,000.00	$6,313.44
Asuris Northwest Health Facility/Professional Facility Modifier 62 Low / Median / High Price $338.85 / $1,126.85 / $1,126.85	Facility	62	$338.85	$1,126.85	$1,126.85
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $54.22 / $180.30 / $180.30	Facility	AS	$54.22	$180.30	$180.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $765.00 / $870.49	Facility		$714.97	$765.00	$870.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $376.03 / $754.49 / $1,009.93	Facility		$376.03	$754.49	$1,009.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $565.90 / $744.18 / $793.95	Facility		$565.90	$744.18	$793.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $529.55 / $529.55 / $541.54	Facility		$529.55	$529.55	$541.54
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $4,016.00 / $16,315.00	Facility		$2,912.00	$4,016.00	$16,315.00