Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,519.65 / $3,023.40 / $22,024.00	Facility		$1,519.65	$3,023.40	$22,024.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,619.48 / $22,267.04	Facility		$55.00	$1,619.48	$22,267.04
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $167.93 / $552.54 / $552.54	Facility	AS	$167.93	$552.54	$552.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,125.30 / $1,996.50 / $3,024.51	Facility		$1,125.30	$1,996.50	$3,024.51
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,129.88 / $2,305.46 / $2,425.40	Facility		$1,129.88	$2,305.46	$2,425.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,619.48 / $1,619.48 / $1,654.34	Facility		$1,619.48	$1,619.48	$1,654.34
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