Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $699.00 / $6,259.76 / $20,076.75	Facility		$699.00	$6,259.76	$20,076.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $558.10 / $4,231.08	Facility		$55.00	$558.10	$4,231.08
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $56.89 / $187.11 / $187.11	Facility	AS	$56.89	$187.11	$187.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $501.21 / $873.94 / $1,074.71	Facility		$501.21	$873.94	$1,074.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $538.55 / $782.66 / $820.08	Facility		$538.55	$782.66	$820.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $558.10 / $558.10 / $559.37	Facility		$558.10	$558.10	$559.37
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