Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $924.38 / $2,291.00 / $18,711.00	Facility		$924.38	$2,291.00	$18,711.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $5,000.00 / $12,045.46	Facility		$55.00	$5,000.00	$12,045.46
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $103.39 / $343.79 / $343.79	Facility	AS	$103.39	$343.79	$343.79
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 $715.79 / $1,437.29 / $1,819.49	Facility		$715.79	$1,437.29	$1,819.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,092.21 / $1,419.29 / $1,514.87	Facility		$1,092.21	$1,419.29	$1,514.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,010.64 / $1,010.64 / $1,033.28	Facility		$1,010.64	$1,010.64	$1,033.28
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