Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $565.72 / $3,463.48 / $18,711.00	Facility		$565.72	$3,463.48	$18,711.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $409.02 / $611.20 / $7,561.00	Facility		$409.02	$611.20	$7,561.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $401.45 / $862.58 / $1,055.58	Facility		$401.45	$862.58	$1,055.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $492.25 / $599.65 / $831.47	Facility		$492.25	$599.65	$831.47
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $409.02 / $409.02 / $414.50	Facility		$409.02	$409.02	$414.50
United Facility/Professional Facility Modifier Low / Median / High Price $497.00 / $1,078.00 / $61,876.00	Facility		$497.00	$1,078.00	$61,876.00