Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,221.81 / $4,259.68 / $20,680.40	Facility		$2,221.81	$4,259.68	$20,680.40
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,110.91 / $1,499.99 / $2,342.00	Facility	52	$1,110.91	$1,499.99	$2,342.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,214.71 / $15,192.88	Facility		$55.00	$2,214.71	$15,192.88
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,825.75 / $5,982.62 / $5,982.62	Facility	52	$1,825.75	$5,982.62	$5,982.62
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $228.22 / $747.83 / $747.83	Facility	AS	$228.22	$747.83	$747.83
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 $1,560.85 / $3,249.96 / $4,125.43	Facility		$1,560.85	$3,249.96	$4,125.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,357.88 / $3,152.38 / $3,297.74	Facility		$2,357.88	$3,152.38	$3,297.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,214.71 / $2,214.71 / $2,249.35	Facility		$2,214.71	$2,214.71	$2,249.35
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