Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,694.70 / $5,531.63 / $20,680.40	Facility		$2,694.70	$5,531.63	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,962.62 / $30,515.88	Facility		$55.00	$2,962.62	$30,515.88
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $304.77 / $1,020.61 / $1,020.61	Facility	AS	$304.77	$1,020.61	$1,020.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,613.75 / $4,380.99 / $5,530.42	Facility		$2,613.75	$4,380.99	$5,530.42
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,102.74 / $4,192.80 / $4,496.37	Facility		$3,102.74	$4,192.80	$4,496.37
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,962.62 / $2,962.62 / $3,066.93	Facility		$2,962.62	$2,962.62	$3,066.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,120.00 / $2,180.80 / $5,793.00	Facility		$1,120.00	$2,180.80	$5,793.00