Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $247.42 / $575.14 / $1,369.00	Facility		$247.42	$575.14	$1,369.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $468.10 / $888.99 / $1,701.50	Facility		$468.10	$888.99	$1,701.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $270.29 / $440.23 / $824.46	Facility		$270.29	$440.23	$824.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $358.45 / $565.27 / $650.57	Facility		$358.45	$565.27	$650.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $443.75 / $443.75 / $445.75	Facility		$443.75	$443.75	$445.75
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $576.79 / $888.99 / $1,701.50	Facility		$576.79	$888.99	$1,701.50
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