Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,155.17 / $3,371.36 / $20,680.40	Facility		$2,155.17	$3,371.36	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $10,160.00 / $15,140.95	Facility		$55.00	$10,160.00	$15,140.95
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $166.00 / $544.37 / $544.37	Facility	AS	$166.00	$544.37	$544.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,417.78 / $2,430.48 / $3,011.31	Facility		$1,417.78	$2,430.48	$3,011.31
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,690.56 / $2,292.31 / $2,390.56	Facility		$1,690.56	$2,292.31	$2,390.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,595.47 / $1,595.47 / $1,630.58	Facility		$1,595.47	$1,595.47	$1,630.58
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