Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $453.25 / $4,500.00 / $22,024.00	Facility		$453.25	$4,500.00	$22,024.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $474.37 / $2,396.40	Facility		$55.00	$474.37	$2,396.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $435.85 / $759.98 / $934.57	Facility		$435.85	$759.98	$934.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $455.26 / $657.35 / $710.87	Facility		$455.26	$657.35	$710.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $474.37 / $474.37 / $479.73	Facility		$474.37	$474.37	$479.73
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