Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $322.39 / $1,115.96 / $20,680.40	Facility		$322.39	$1,115.96	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $343.83 / $1,300.00	Facility		$55.00	$343.83	$1,300.00
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $34.99 / $114.90 / $114.90	Facility	AS	$34.99	$114.90	$114.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $243.04 / $540.85 / $656.85	Facility		$243.04	$540.85	$656.85
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $376.88 / $480.67 / $515.44	Facility		$376.88	$480.67	$515.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $343.83 / $343.83 / $345.95	Facility		$343.83	$343.83	$345.95
United Facility/Professional Facility Modifier Low / Median / High Price $4,252.00 / $25,743.00 / $37,152.00	Facility		$4,252.00	$25,743.00	$37,152.00