Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,469.30 / $4,651.13 / $20,680.40	Facility		$2,469.30	$4,651.13	$20,680.40
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,234.65 / $1,650.44 / $2,578.35	Facility	52	$1,234.65	$1,650.44	$2,578.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,475.57 / $16,686.80	Facility		$55.00	$2,475.57	$16,686.80
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,999.94 / $6,572.37 / $6,572.37	Facility	52	$1,999.94	$6,572.37	$6,572.37
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $249.99 / $821.55 / $821.55	Facility	AS	$249.99	$821.55	$821.55
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 $1,725.15 / $3,450.16 / $4,539.60	Facility		$1,725.15	$3,450.16	$4,539.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,596.51 / $3,453.98 / $3,629.39	Facility		$2,596.51	$3,453.98	$3,629.39
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,448.01 / $2,448.01 / $2,475.57	Facility		$2,448.01	$2,448.01	$2,475.57
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