Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $530.63 / $6,470.00 / $21,917.86	Facility		$530.63	$6,470.00	$21,917.86
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $383.69 / $2,304.75 / $26,542.00	Facility		$383.69	$2,304.75	$26,542.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $415.72 / $512.00 / $857.01	Facility		$415.72	$512.00	$857.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $473.00 / $575.96 / $683.40	Facility		$473.00	$575.96	$683.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $383.69 / $383.69 / $393.02	Facility		$383.69	$383.69	$393.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,152.97 / $4,152.97 / $5,232.12	Facility		$4,152.97	$4,152.97	$5,232.12
United Facility/Professional Facility Modifier Low / Median / High Price $118.00 / $414.00 / $5,793.00	Facility		$118.00	$414.00	$5,793.00