Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,023.39 / $5,128.00 / $18,800.00	Facility		$1,023.39	$5,128.00	$18,800.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,084.94 / $8,399.34	Facility		$55.00	$1,084.94	$8,399.34
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $763.84 / $1,699.73 / $2,047.90	Facility		$763.84	$1,699.73	$2,047.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,178.94 / $1,546.38 / $1,628.10	Facility		$1,178.94	$1,546.38	$1,628.10
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,084.94 / $1,084.94 / $1,110.51	Facility		$1,084.94	$1,084.94	$1,110.51
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