Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,395.40 / $2,865.75 / $22,024.00	Facility		$1,395.40	$2,865.75	$22,024.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,501.70 / $13,940.30	Facility		$55.00	$1,501.70	$13,940.30
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $152.16 / $501.38 / $501.38	Facility	AS	$152.16	$501.38	$501.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,060.51 / $2,285.77 / $2,867.78	Facility		$1,060.51	$2,285.77	$2,867.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,627.78 / $2,086.02 / $2,242.64	Facility		$1,627.78	$2,086.02	$2,242.64
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,501.70 / $1,501.70 / $1,512.67	Facility		$1,501.70	$1,501.70	$1,512.67
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