Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,031.17 / $5,128.00 / $20,680.40	Facility		$1,031.17	$5,128.00	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,108.04 / $1,993.85 / $4,409.49	Facility		$1,108.04	$1,993.85	$4,409.49
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $112.22 / $369.22 / $369.22	Facility	AS	$112.22	$369.22	$369.22
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $635.54 / $1,738.55 / $2,292.29	Facility		$635.54	$1,738.55	$2,292.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,152.90 / $1,541.03 / $1,649.68	Facility		$1,152.90	$1,541.03	$1,649.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,108.04 / $1,108.04 / $1,112.80	Facility		$1,108.04	$1,108.04	$1,112.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,454.88 / $1,992.71 / $3,814.01	Facility		$1,454.88	$1,992.71	$3,814.01
United Facility/Professional Facility Modifier Low / Median / High Price $648.00 / $1,875.00 / $4,911.00	Facility		$648.00	$1,875.00	$4,911.00