Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,613.05 / $4,965.37 / $20,680.40	Facility		$2,613.05	$4,965.37	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $4,000.25 / $27,063.48	Facility		$55.00	$4,000.25	$27,063.48
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $271.89 / $895.72 / $895.72	Facility	AS	$271.89	$895.72	$895.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $870.49 / $947.00	Facility		$500.00	$870.49	$947.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,848.84 / $3,785.63 / $4,899.75	Facility		$1,848.84	$3,785.63	$4,899.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,793.00 / $3,748.00 / $3,935.58	Facility		$2,793.00	$3,748.00	$3,935.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,640.54 / $3,277.62 / $6,637.66	Facility		$2,640.54	$3,277.62	$6,637.66
United Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $1,120.00 / $5,793.00	Facility		$650.00	$1,120.00	$5,793.00