Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $298.98 / $679.15 / $20,680.40	Facility		$298.98	$679.15	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $316.19 / $1,065.73	Facility		$55.00	$316.19	$1,065.73
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $224.13 / $498.80 / $603.33	Facility		$224.13	$498.80	$603.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $336.24 / $450.44 / $466.99	Facility		$336.24	$450.44	$466.99
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $316.19 / $316.19 / $318.52	Facility		$316.19	$316.19	$318.52
United Facility/Professional Facility Modifier Low / Median / High Price $1,120.00 / $3,323.00 / $36,803.00	Facility		$1,120.00	$3,323.00	$36,803.00