Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $468.91 / $995.92 / $20,680.40	Facility		$468.91	$995.92	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $478.48 / $1,638.00	Facility		$55.00	$478.48	$1,638.00
Asuris Northwest Health Facility/Professional Facility Modifier 62 Low / Median / High Price $302.33 / $992.48 / $992.48	Facility	62	$302.33	$992.48	$992.48
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $48.37 / $158.80 / $158.80	Facility	AS	$48.37	$158.80	$158.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $714.97 / $947.00	Facility		$500.00	$714.97	$947.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $330.77 / $707.16 / $874.65	Facility		$330.77	$707.16	$874.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $502.74 / $665.34 / $701.49	Facility		$502.74	$665.34	$701.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $472.03 / $472.03 / $478.48	Facility		$472.03	$472.03	$478.48
United Facility/Professional Facility Modifier Low / Median / High Price $1,400.00 / $3,509.00 / $16,315.00	Facility		$1,400.00	$3,509.00	$16,315.00