Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,626.73 / $3,669.16 / $20,680.40	Facility		$1,626.73	$3,669.16	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,694.22 / $11,858.00	Facility		$55.00	$1,694.22	$11,858.00
Asuris Northwest Health Facility/Professional Facility Modifier 62 Low / Median / High Price $1,116.51 / $3,618.02 / $3,618.02	Facility	62	$1,116.51	$3,618.02	$3,618.02
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $178.64 / $578.88 / $578.88	Facility	AS	$178.64	$578.88	$578.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,507.16 / $2,681.77 / $3,256.96	Facility		$1,507.16	$2,681.77	$3,256.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,806.14 / $2,436.12 / $2,547.34	Facility		$1,806.14	$2,436.12	$2,547.34
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,694.22 / $1,694.22 / $1,737.51	Facility		$1,694.22	$1,694.22	$1,737.51
United Facility/Professional Facility Modifier Low / Median / High Price $703.00 / $2,446.00 / $36,803.00	Facility		$703.00	$2,446.00	$36,803.00