Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.92 / $665.75 / $15,000.00	Facility		$173.92	$665.75	$15,000.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $253.68 / $676.68	Facility		$55.00	$253.68	$676.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $182.65 / $320.58 / $455.21	Facility		$182.65	$320.58	$455.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $231.15 / $353.09 / $385.25	Facility		$231.15	$353.09	$385.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $253.68 / $253.68 / $262.77	Facility		$253.68	$253.68	$262.77
United Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $666.00 / $6,216.00	Facility		$190.00	$666.00	$6,216.00