Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $172.20 / $2,477.88 / $12,214.00	Facility		$172.20	$2,477.88	$12,214.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $64.20 / $139.55 / $1,942.57	Facility	52	$64.20	$139.55	$1,942.57
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $242.60 / $1,556.06	Facility		$55.00	$242.60	$1,556.06
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $194.08 / $341.53 / $341.53	Facility	52	$194.08	$341.53	$341.53
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $148.54 / $1,249.30 / $3,084.15	Facility		$148.54	$1,249.30	$3,084.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $276.92 / $1,994.99 / $2,628.52	Facility		$276.92	$1,994.99	$2,628.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,453.72 / $1,453.72 / $1,556.06	Facility		$1,453.72	$1,453.72	$1,556.06
United Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $666.00 / $6,216.00	Facility		$190.00	$666.00	$6,216.00