Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,310.96 / $22,024.00	Facility		$1,733.00	$5,310.96	$22,024.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $10,160.00 / $11,173.12	Facility		$55.00	$10,160.00	$11,173.12
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $168.32 / $545.58 / $545.58	Facility	AS	$168.32	$545.58	$545.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,416.96 / $2,518.65 / $3,058.85	Facility		$1,416.96	$2,518.65	$3,058.85
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,695.89 / $2,285.37 / $2,399.27	Facility		$1,695.89	$2,285.37	$2,399.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,593.65 / $1,593.65 / $1,636.52	Facility		$1,593.65	$1,593.65	$1,636.52
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