Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,303.37 / $2,821.99 / $3,550.22	Facility		$2,303.37	$2,821.99	$3,550.22
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,727.00 / $34,428.37 / $70,064.83	Facility		$1,727.00	$34,428.37	$70,064.83
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $175.99 / $576.61 / $576.61	Facility	AS	$175.99	$576.61	$576.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,198.40 / $2,505.42 / $3,814.68	Facility		$1,198.40	$2,505.42	$3,814.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,762.53 / $2,419.37 / $2,531.92	Facility		$1,762.53	$2,419.37	$2,531.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,684.25 / $1,727.00 / $19,515.89	Facility		$1,684.25	$1,727.00	$19,515.89
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $27,977.90 / $36,627.79 / $70,064.83	Facility		$27,977.90	$36,627.79	$70,064.83