Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,646.60 / $3,133.39 / $20,680.40	Facility		$1,646.60	$3,133.39	$20,680.40
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $823.30 / $1,110.68 / $1,722.75	Facility	52	$823.30	$1,110.68	$1,722.75
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $329.32 / $444.27 / $689.10	Facility	53	$329.32	$444.27	$689.10
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,647.11 / $11,255.12	Facility		$55.00	$1,647.11	$11,255.12
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,354.58 / $4,456.67 / $4,456.67	Facility	52	$1,354.58	$4,456.67	$4,456.67
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $338.65 / $1,114.17 / $1,114.17	Facility	53	$338.65	$1,114.17	$1,114.17
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $169.32 / $557.08 / $557.08	Facility	AS	$169.32	$557.08	$557.08
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 $1,151.65 / $2,359.32 / $3,055.27	Facility		$1,151.65	$2,359.32	$3,055.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,739.50 / $2,335.48 / $2,451.53	Facility		$1,739.50	$2,335.48	$2,451.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,647.11 / $1,647.11 / $1,672.16	Facility		$1,647.11	$1,647.11	$1,672.16
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