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 / $22,671.14	Facility		$1,733.00	$6,470.00	$22,671.14
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $8,325.59 / $21,000.00	Facility		$55.00	$8,325.59	$21,000.00
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $142.59 / $464.74 / $464.74	Facility	AS	$142.59	$464.74	$464.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,213.59 / $2,024.33 / $2,534.94	Facility		$1,213.59	$2,024.33	$2,534.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,405.53 / $1,943.67 / $2,051.54	Facility		$1,405.53	$1,943.67	$2,051.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,361.72 / $1,361.72 / $1,399.33	Facility		$1,361.72	$1,361.72	$1,399.33
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,297.00 / $12,835.00	Facility		$2,155.00	$3,297.00	$12,835.00