Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $922.26 / $5,116.62 / $19,900.00	Facility		$922.26	$5,116.62	$19,900.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $974.40 / $13,873.67 / $27,141.02	Facility		$974.40	$13,873.67	$27,141.02
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $101.92 / $333.49 / $333.49	Facility	AS	$101.92	$333.49	$333.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $875.53 / $1,269.04 / $17,411.84	Facility		$875.53	$1,269.04	$17,411.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $842.17 / $1,394.94 / $1,464.62	Facility		$842.17	$1,394.94	$1,464.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $974.40 / $974.40 / $999.00	Facility		$974.40	$974.40	$999.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,837.80 / $14,188.51 / $27,141.02	Facility		$10,837.80	$14,188.51	$27,141.02
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $11,540.00 / $20,708.00	Facility		$3,028.00	$11,540.00	$20,708.00