Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,248.44 / $4,564.21 / $20,680.40	Facility		$2,248.44	$4,564.21	$20,680.40
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $449.69 / $698.12 / $1,018.24	Facility	53	$449.69	$698.12	$1,018.24
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,393.19 / $32,515.84	Facility		$55.00	$2,393.19	$32,515.84
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $487.98 / $1,602.53 / $1,602.53	Facility	53	$487.98	$1,602.53	$1,602.53
Asuris Northwest Health Facility/Professional Facility Modifier 62 Low / Median / High Price $1,524.94 / $5,007.89 / $5,007.89	Facility	62	$1,524.94	$5,007.89	$5,007.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,692.60 / $3,775.23 / $4,434.16	Facility		$1,692.60	$3,775.23	$4,434.16
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,539.75 / $3,358.69 / $3,540.28	Facility		$2,539.75	$3,358.69	$3,540.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,393.19 / $2,393.19 / $2,414.79	Facility		$2,393.19	$2,393.19	$2,414.79
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