Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.55 / $794.87 / $20,680.40	Facility		$338.55	$794.87	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $377.35 / $1,332.36	Facility		$55.00	$377.35	$1,332.36
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $38.45 / $133.24 / $133.24	Facility	AS	$38.45	$133.24	$133.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $335.38 / $595.95 / $819.37	Facility		$335.38	$595.95	$819.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $413.07 / $525.44 / $575.28	Facility		$413.07	$525.44	$575.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $377.35 / $377.35 / $387.99	Facility		$377.35	$377.35	$387.99
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