Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $428.66 / $998.48 / $20,680.40	Facility		$428.66	$998.48	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $468.40 / $1,554.70	Facility		$55.00	$468.40	$1,554.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $328.29 / $735.87 / $893.70	Facility		$328.29	$735.87	$893.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $513.03 / $644.05 / $704.84	Facility		$513.03	$644.05	$704.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $468.40 / $468.40 / $470.25	Facility		$468.40	$468.40	$470.25
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