Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,688.90 / $9,305.92 / $23,000.00	Facility		$1,688.90	$9,305.92	$23,000.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,833.03 / $16,904.80	Facility		$55.00	$1,833.03	$16,904.80
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $184.76 / $608.10 / $608.10	Facility	AS	$184.76	$608.10	$608.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,686.99 / $2,929.07 / $3,617.25	Facility		$1,686.99	$2,929.07	$3,617.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,761.26 / $2,530.82 / $2,704.12	Facility		$1,761.26	$2,530.82	$2,704.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,824.23 / $1,824.23 / $1,833.03	Facility		$1,824.23	$1,824.23	$1,833.03
United Facility/Professional Facility Modifier Low / Median / High Price $1,299.35 / $2,446.00 / $5,793.00	Facility		$1,299.35	$2,446.00	$5,793.00