Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.92 / $227.31 / $20,680.40	Facility		$97.92	$227.31	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $105.55 / $1,974.00	Facility		$55.00	$105.55	$1,974.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $74.70 / $167.47 / $203.39	Facility		$74.70	$167.47	$203.39
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $119.95 / $145.80 / $161.04	Facility		$119.95	$145.80	$161.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $105.55 / $105.55 / $106.48	Facility		$105.55	$105.55	$106.48
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