Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $904.31 / $1,872.05 / $20,680.40	Facility		$904.31	$1,872.05	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $971.69 / $3,247.12	Facility		$55.00	$971.69	$3,247.12
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $98.73 / $324.70 / $324.70	Facility	AS	$98.73	$324.70	$324.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $681.38 / $1,520.32 / $1,846.40	Facility		$681.38	$1,520.32	$1,846.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,120.63 / $1,353.08 / $1,455.20	Facility		$1,120.63	$1,353.08	$1,455.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $971.69 / $971.69 / $977.52	Facility		$971.69	$971.69	$977.52
United Facility/Professional Facility Modifier Low / Median / High Price $1,120.00 / $2,446.00 / $5,793.00	Facility		$1,120.00	$2,446.00	$5,793.00