Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.61 / $167.63 / $13,809.00	Facility		$88.61	$167.63	$13,809.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $86.98 / $214.95	Facility		$55.00	$86.98	$214.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $60.45 / $112.72 / $172.72	Facility		$60.45	$112.72	$172.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $89.15 / $123.28 / $133.62	Facility		$89.15	$123.28	$133.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $86.98 / $86.98 / $88.20	Facility		$86.98	$86.98	$88.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,764.72 / $1,764.72 / $2,223.27	Facility		$1,764.72	$1,764.72	$2,223.27
United Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $666.00 / $6,216.00	Facility		$190.00	$666.00	$6,216.00