Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $382.43 / $867.10 / $20,680.40	Facility		$382.43	$867.10	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $382.05 / $2,291.44	Facility		$55.00	$382.05	$2,291.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $347.34 / $624.95 / $758.99	Facility		$347.34	$624.95	$758.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $419.58 / $553.04 / $580.22	Facility		$419.58	$553.04	$580.22
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $382.05 / $382.05 / $389.13	Facility		$382.05	$382.05	$389.13
United Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $666.00 / $6,216.00	Facility		$190.00	$666.00	$6,216.00