Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,240.84 / $5,128.00 / $18,800.00	Facility		$1,240.84	$5,128.00	$18,800.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,320.50 / $10,010.87	Facility		$55.00	$1,320.50	$10,010.87
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $133.19 / $441.81 / $441.81	Facility	AS	$133.19	$441.81	$441.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $986.11 / $2,091.62 / $2,643.62	Facility		$986.11	$2,091.62	$2,643.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,590.06 / $1,828.77 / $2,089.44	Facility		$1,590.06	$1,828.77	$2,089.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,320.50 / $1,320.50 / $1,327.13	Facility		$1,320.50	$1,320.50	$1,327.13
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