Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $565.20 / $2,123.80 / $18,711.00	Facility		$565.20	$2,123.80	$18,711.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $409.47 / $611.80 / $7,561.00	Facility		$409.47	$611.80	$7,561.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $400.83 / $861.17 / $1,056.43	Facility		$400.83	$861.17	$1,056.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $492.80 / $600.32 / $829.46	Facility		$492.80	$600.32	$829.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $409.47 / $409.47 / $414.04	Facility		$409.47	$409.47	$414.04
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