Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $502.00 / $519.00 / $1,196.00	Facility		$502.00	$519.00	$1,196.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $333.00 / $559.08 / $2,900.00	Facility		$333.00	$559.08	$2,900.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $260.00 / $400.00 / $800.00	Facility		$260.00	$400.00	$800.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $536.00 / $551.20 / $625.00	Facility		$536.00	$551.20	$625.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $333.00 / $485.00 / $963.44	Facility		$333.00	$485.00	$963.44