Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $284.42 / $646.41 / $20,680.40	Facility		$284.42	$646.41	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $305.32 / $1,931.00	Facility		$55.00	$305.32	$1,931.00
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $30.99 / $101.88 / $101.88	Facility	AS	$30.99	$101.88	$101.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $213.90 / $477.77 / $580.24	Facility		$213.90	$477.77	$580.24
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $349.32 / $424.86 / $457.64	Facility		$349.32	$424.86	$457.64
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $305.32 / $305.32 / $308.48	Facility		$305.32	$305.32	$308.48
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