Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,194.06 / $4,865.97 / $22,024.00	Facility		$2,194.06	$4,865.97	$22,024.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,527.29 / $12,650.00 / $19,828.25	Facility		$2,527.29	$12,650.00	$19,828.25
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,106.59 / $6,866.68 / $6,866.68	Facility	52	$2,106.59	$6,866.68	$6,866.68
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $263.32 / $858.34 / $858.34	Facility	AS	$263.32	$858.34	$858.34
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,209.90 / $3,785.33 / $4,778.47	Facility		$2,209.90	$3,785.33	$4,778.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,655.06 / $3,617.33 / $3,800.24	Facility		$2,655.06	$3,617.33	$3,800.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,527.29 / $2,527.29 / $2,592.10	Facility		$2,527.29	$2,527.29	$2,592.10
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $3,509.00 / $17,644.00	Facility		$2,912.00	$3,509.00	$17,644.00