Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $231.00 / $526.49 / $20,680.40	Facility		$231.00	$526.49	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $249.15 / $1,300.00	Facility		$55.00	$249.15	$1,300.00
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $25.23 / $82.96 / $82.96	Facility	AS	$25.23	$82.96	$82.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $174.22 / $388.60 / $471.94	Facility		$174.22	$388.60	$471.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $267.54 / $345.87 / $371.28	Facility		$267.54	$345.87	$371.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $249.15 / $249.15 / $250.44	Facility		$249.15	$249.15	$250.44
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