Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.69 / $2,769.52 / $18,711.00	Facility		$149.69	$2,769.52	$18,711.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $13,212.00 / $13,212.00 / $13,212.00	Facility	50	$13,212.00	$13,212.00	$13,212.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,000.00 / $2,000.00	Facility		$55.00	$2,000.00	$2,000.00
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $442.67 / $442.67 / $442.67	Facility	50	$442.67	$442.67	$442.67
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $79.05 / $166.70 / $226.13	Facility		$79.05	$166.70	$226.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $121.52 / $159.79 / $163.47	Facility		$121.52	$159.79	$163.47
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.81 / $107.81 / $111.51	Facility		$107.81	$107.81	$111.51
United Facility/Professional Facility Modifier Low / Median / High Price $414.00 / $666.00 / $6,216.00	Facility		$414.00	$666.00	$6,216.00