Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,877.69 / $9,305.92 / $23,000.00	Facility		$1,877.69	$9,305.92	$23,000.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,038.22 / $18,796.03	Facility		$55.00	$2,038.22	$18,796.03
Asuris Northwest Health Facility/Professional Facility Modifier 62 Low / Median / High Price $1,283.69 / $4,223.56 / $4,223.56	Facility	62	$1,283.69	$4,223.56	$4,223.56
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $205.39 / $675.77 / $675.77	Facility	AS	$205.39	$675.77	$675.77
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,860.14 / $3,243.42 / $3,988.53	Facility		$1,860.14	$3,243.42	$3,988.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,957.29 / $2,813.59 / $2,988.20	Facility		$1,957.29	$2,813.59	$2,988.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,026.72 / $2,026.72 / $2,038.22	Facility		$2,026.72	$2,026.72	$2,038.22
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