Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $322.72 / $3,463.48 / $18,711.00	Facility		$322.72	$3,463.48	$18,711.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $240.54 / $1,300.00	Facility		$55.00	$240.54	$1,300.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $171.74 / $381.35 / $463.14	Facility		$171.74	$381.35	$463.14
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $256.79 / $343.54 / $357.11	Facility		$256.79	$343.54	$357.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $240.54 / $240.54 / $243.58	Facility		$240.54	$240.54	$243.58
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