Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $206.27 / $493.75 / $20,680.40	Facility		$206.27	$493.75	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $220.61 / $2,059.42	Facility		$55.00	$220.61	$2,059.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $164.61 / $358.54 / $468.30	Facility		$164.61	$358.54	$468.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $247.10 / $309.49 / $344.35	Facility		$247.10	$309.49	$344.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $220.61 / $220.61 / $222.10	Facility		$220.61	$220.61	$222.10
United Facility/Professional Facility Modifier Low / Median / High Price $1,120.00 / $3,323.00 / $36,803.00	Facility		$1,120.00	$3,323.00	$36,803.00