Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $386.77 / $2,769.52 / $18,711.00	Facility		$386.77	$2,769.52	$18,711.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $289.92 / $1,300.00	Facility		$55.00	$289.92	$1,300.00
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $29.55 / $99.16 / $99.16	Facility	AS	$29.55	$99.16	$99.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $255.43 / $439.72 / $554.71	Facility		$255.43	$439.72	$554.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $317.52 / $404.01 / $436.84	Facility		$317.52	$404.01	$436.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $289.92 / $289.92 / $297.95	Facility		$289.92	$289.92	$297.95
United Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $666.00 / $6,216.00	Facility		$190.00	$666.00	$6,216.00