Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.37 / $4,500.00 / $22,024.00	Facility		$161.37	$4,500.00	$22,024.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $173.20 / $576.76	Facility		$55.00	$173.20	$576.76
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $17.53 / $57.68 / $57.68	Facility	AS	$17.53	$57.68	$57.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $157.02 / $273.80 / $336.70	Facility		$157.02	$273.80	$336.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $166.76 / $240.25 / $253.93	Facility		$166.76	$240.25	$253.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.20 / $173.20 / $173.95	Facility		$173.20	$173.20	$173.95
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