Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.31 / $9,765.45 / $27,982.24	Facility		$68.31	$9,765.45	$27,982.24
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $113.70 / $147.50 / $3,779.00	Facility		$113.70	$147.50	$3,779.00
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $11.76 / $38.45 / $38.45	Facility	AS	$11.76	$38.45	$38.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $82.95 / $153.12 / $208.03	Facility		$82.95	$153.12	$208.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $123.83 / $162.52 / $170.68	Facility		$123.83	$162.52	$170.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.70 / $113.70 / $116.08	Facility		$113.70	$113.70	$116.08
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $546.00 / $5,793.00	Facility		$157.00	$546.00	$5,793.00