Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $240.63 / $585.07 / $20,680.40	Facility		$240.63	$585.07	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $263.19 / $1,300.00	Facility		$55.00	$263.19	$1,300.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $193.75 / $425.59 / $526.53	Facility		$193.75	$425.59	$526.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $299.88 / $371.08 / $407.36	Facility		$299.88	$371.08	$407.36
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $263.19 / $263.19 / $270.08	Facility		$263.19	$263.19	$270.08
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