Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.44 / $1,733.00 / $14,464.32	Facility		$115.44	$1,733.00	$14,464.32
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $161.41 / $698.98	Facility		$55.00	$161.41	$698.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $93.00 / $610.08 / $1,671.56	Facility		$93.00	$610.08	$1,671.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $125.29 / $922.65 / $1,299.52	Facility		$125.29	$922.65	$1,299.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $662.19 / $662.19 / $698.98	Facility		$662.19	$662.19	$698.98
United Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $666.00 / $6,216.00	Facility		$190.00	$666.00	$6,216.00