Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,139.41 / $4,500.00 / $22,024.00	Facility		$1,139.41	$4,500.00	$22,024.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,222.65 / $26,791.18	Facility		$55.00	$1,222.65	$26,791.18
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $124.16 / $408.43 / $408.43	Facility	AS	$124.16	$408.43	$408.43
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,252.82 / $2,140.19 / $2,614.92	Facility		$1,252.82	$2,140.19	$2,614.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,182.72 / $1,701.56 / $1,804.98	Facility		$1,182.72	$1,701.56	$1,804.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,222.65 / $1,222.65 / $1,228.42	Facility		$1,222.65	$1,222.65	$1,228.42
United Facility/Professional Facility Modifier Low / Median / High Price $497.00 / $1,078.00 / $6,216.00	Facility		$497.00	$1,078.00	$6,216.00