Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $889.56 / $3,170.00 / $12,214.00	Facility		$889.56	$3,170.00	$12,214.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $5,000.00 / $11,575.34	Facility		$55.00	$5,000.00	$11,575.34
Asuris Northwest Health Facility/Professional Facility Modifier 62 Low / Median / High Price $620.63 / $2,062.56 / $2,062.56	Facility	62	$620.63	$2,062.56	$2,062.56
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $99.30 / $330.01 / $330.01	Facility	AS	$99.30	$330.01	$330.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $765.00 / $870.49 / $870.49	Facility		$765.00	$870.49	$870.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $689.75 / $1,402.21 / $1,819.02	Facility		$689.75	$1,402.21	$1,819.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,051.54 / $1,363.33 / $1,455.24	Facility		$1,051.54	$1,363.33	$1,455.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $972.14 / $972.14 / $992.60	Facility		$972.14	$972.14	$992.60
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $5,547.00 / $19,271.00	Facility		$3,028.00	$5,547.00	$19,271.00