Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $305.17 / $1,797.35 / $13,750.00	Facility		$305.17	$1,797.35	$13,750.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,133.82 / $1,557.12	Facility		$55.00	$1,133.82	$1,557.12
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $262.58 / $765.70 / $2,174.83	Facility		$262.58	$765.70	$2,174.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $333.66 / $1,577.75 / $1,723.94	Facility		$333.66	$1,577.75	$1,723.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,133.82 / $1,133.82 / $1,198.19	Facility		$1,133.82	$1,133.82	$1,198.19
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