Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $736.54 / $1,642.81 / $20,680.40	Facility		$736.54	$1,642.81	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $774.63 / $2,628.01	Facility		$55.00	$774.63	$2,628.01
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $79.92 / $262.80 / $262.80	Facility	AS	$79.92	$262.80	$262.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $548.39 / $1,209.30 / $1,468.67	Facility		$548.39	$1,209.30	$1,468.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $879.06 / $1,103.47 / $1,158.04	Facility		$879.06	$1,103.47	$1,158.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $774.63 / $774.63 / $788.33	Facility		$774.63	$774.63	$788.33
United Facility/Professional Facility Modifier Low / Median / High Price $1,120.00 / $3,323.00 / $36,803.00	Facility		$1,120.00	$3,323.00	$36,803.00