Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $500.73 / $1,087.97 / $20,680.40	Facility		$500.73	$1,087.97	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $522.76 / $2,261.10	Facility		$55.00	$522.76	$2,261.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $363.01 / $784.30 / $969.43	Facility		$363.01	$784.30	$969.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $550.27 / $746.38 / $785.91	Facility		$550.27	$746.38	$785.91
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $522.76 / $522.76 / $536.05	Facility		$522.76	$522.76	$536.05
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