Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $521.00 / $4,414.79 / $18,711.00	Facility		$521.00	$4,414.79	$18,711.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $396.83 / $1,318.54	Facility		$55.00	$396.83	$1,318.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $368.37 / $631.69 / $789.88	Facility		$368.37	$631.69	$789.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $383.24 / $547.25 / $586.25	Facility		$383.24	$547.25	$586.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $396.83 / $396.83 / $398.05	Facility		$396.83	$396.83	$398.05
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