Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $988.00 / $9,350.64 / $21,917.86	Facility		$988.00	$9,350.64	$21,917.86
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,064.81 / $9,827.51	Facility		$55.00	$1,064.81	$9,827.51
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $107.39 / $353.33 / $353.33	Facility	AS	$107.39	$353.33	$353.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $976.12 / $1,700.27 / $2,093.00	Facility		$976.12	$1,700.27	$2,093.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,023.47 / $1,473.23 / $1,561.77	Facility		$1,023.47	$1,473.23	$1,561.77
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,055.49 / $1,055.49 / $1,064.81	Facility		$1,055.49	$1,055.49	$1,064.81
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