Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.57 / $334.53 / $12,214.00	Facility		$119.57	$334.53	$12,214.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $44.59 / $88.44 / $167.26	Facility	52	$44.59	$88.44	$167.26
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $164.44 / $538.02	Facility		$55.00	$164.44	$538.02
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $135.34 / $237.37 / $237.37	Facility	52	$135.34	$237.37	$237.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $94.55 / $160.75 / $278.45	Facility		$94.55	$160.75	$278.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $131.32 / $233.16 / $241.20	Facility		$131.32	$233.16	$241.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $164.44 / $164.44 / $164.52	Facility		$164.44	$164.44	$164.52
United Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $910.00 / $5,793.00	Facility		$190.00	$910.00	$5,793.00