Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $6,470.00 / $27,982.24	Facility		$1,733.00	$6,470.00	$27,982.24
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $10,160.00 / $12,436.64	Facility		$55.00	$10,160.00	$12,436.64
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $187.37 / $606.13 / $606.13	Facility	AS	$187.37	$606.13	$606.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,583.83 / $2,819.52 / $3,424.26	Facility		$1,583.83	$2,819.52	$3,424.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,992.75 / $2,597.44 / $2,667.94	Facility		$1,992.75	$2,597.44	$2,667.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,773.95 / $1,773.95 / $1,819.77	Facility		$1,773.95	$1,773.95	$1,819.77
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