Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $699.00 / $6,259.76 / $18,711.00	Facility		$699.00	$6,259.76	$18,711.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $542.69 / $3,258.08	Facility		$55.00	$542.69	$3,258.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $494.85 / $862.84 / $1,061.06	Facility		$494.85	$862.84	$1,061.06
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $532.40 / $772.94 / $810.70	Facility		$532.40	$772.94	$810.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $542.69 / $542.69 / $552.97	Facility		$542.69	$542.69	$552.97
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