Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $498.23 / $4,414.79 / $20,680.40	Facility		$498.23	$4,414.79	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $491.96 / $1,653.07	Facility		$55.00	$491.96	$1,653.07
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $50.25 / $165.31 / $165.31	Facility	AS	$50.25	$165.31	$165.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $457.50 / $792.61 / $980.98	Facility		$457.50	$792.61	$980.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $478.28 / $688.61 / $735.76	Facility		$478.28	$688.61	$735.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $491.96 / $491.96 / $496.76	Facility		$491.96	$491.96	$496.76
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