Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $527.72 / $1,200.29 / $20,680.40	Facility		$527.72	$1,200.29	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $563.53 / $1,878.65	Facility		$55.00	$563.53	$1,878.65
Asuris Northwest Health Facility/Professional Facility Modifier 62 Low / Median / High Price $357.56 / $1,174.16 / $1,174.16	Facility	62	$357.56	$1,174.16	$1,174.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $414.47 / $885.95 / $1,179.09	Facility		$414.47	$885.95	$1,179.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $600.29 / $785.90 / $831.20	Facility		$600.29	$785.90	$831.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $563.53 / $563.53 / $565.77	Facility		$563.53	$563.53	$565.77
United Facility/Professional Facility Modifier Low / Median / High Price $497.00 / $1,078.00 / $6,216.00	Facility		$497.00	$1,078.00	$6,216.00