Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.63 / $410.52 / $17,100.00	Facility		$115.63	$410.52	$17,100.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $269.47 / $605.89	Facility		$55.00	$269.47	$605.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $765.00 / $870.49	Facility		$714.97	$765.00	$870.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $83.23 / $164.78 / $358.82	Facility		$83.23	$164.78	$358.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $129.97 / $345.72 / $428.13	Facility		$129.97	$345.72	$428.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $292.02 / $292.02 / $298.98	Facility		$292.02	$292.02	$298.98
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $546.00 / $5,793.00	Facility		$157.00	$546.00	$5,793.00