Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $472.60 / $4,497.00 / $22,024.00	Facility		$472.60	$4,497.00	$22,024.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $356.96 / $1,194.38	Facility		$55.00	$356.96	$1,194.38
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $36.29 / $119.44 / $119.44	Facility	AS	$36.29	$119.44	$119.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $329.75 / $572.40 / $707.07	Facility		$329.75	$572.40	$707.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $345.94 / $497.20 / $530.44	Facility		$345.94	$497.20	$530.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $356.96 / $356.96 / $359.66	Facility		$356.96	$356.96	$359.66
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