Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.60 / $1,791.86 / $14,464.32	Facility		$269.60	$1,791.86	$14,464.32
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,055.67 / $1,368.96	Facility		$55.00	$1,055.67	$1,368.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $230.23 / $704.01 / $1,999.94	Facility		$230.23	$704.01	$1,999.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $294.13 / $1,468.49 / $1,665.32	Facility		$294.13	$1,468.49	$1,665.32
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,055.67 / $1,055.67 / $1,109.40	Facility		$1,055.67	$1,055.67	$1,109.40
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