Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $179.63 / $416.93 / $20,680.40	Facility		$179.63	$416.93	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $194.34 / $732.00	Facility		$55.00	$194.34	$732.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $137.94 / $308.43 / $375.09	Facility		$137.94	$308.43	$375.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $217.12 / $268.77 / $294.13	Facility		$217.12	$268.77	$294.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.34 / $194.34 / $195.14	Facility		$194.34	$194.34	$195.14
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