Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.91 / $208.28 / $15,288.72	Facility		$110.91	$208.28	$15,288.72
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $107.81 / $280.05	Facility		$55.00	$107.81	$280.05
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $77.23 / $140.71 / $207.76	Facility		$77.23	$140.71	$207.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $110.95 / $153.43 / $162.50	Facility		$110.95	$153.43	$162.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.81 / $107.81 / $109.68	Facility		$107.81	$107.81	$109.68
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 / $910.00 / $5,793.00	Facility		$190.00	$910.00	$5,793.00