Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $294.04 / $3,740.00 / $18,711.00	Facility		$294.04	$3,740.00	$18,711.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $221.52 / $744.78	Facility		$55.00	$221.52	$744.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $198.61 / $339.30 / $415.99	Facility		$198.61	$339.30	$415.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $215.16 / $310.37 / $327.63	Facility		$215.16	$310.37	$327.63
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $221.52 / $221.52 / $223.47	Facility		$221.52	$221.52	$223.47
United Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $666.00 / $6,216.00	Facility		$190.00	$666.00	$6,216.00