Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $224.57 / $1,944.28 / $14,464.32	Facility		$224.57	$1,944.28	$14,464.32
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,236.66 / $12,500.00	Facility		$55.00	$1,236.66	$12,500.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $186.73 / $680.45 / $1,936.90	Facility		$186.73	$680.45	$1,936.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $247.02 / $1,454.76 / $1,612.82	Facility		$247.02	$1,454.76	$1,612.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,050.64 / $1,050.64 / $1,094.90	Facility		$1,050.64	$1,050.64	$1,094.90
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