Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.31 / $505.36 / $17,100.00	Facility		$92.31	$505.36	$17,100.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $381.99 / $381.99	Facility		$55.00	$381.99	$381.99
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $70.14 / $187.86 / $552.58	Facility		$70.14	$187.86	$552.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $103.44 / $372.70 / $418.88	Facility		$103.44	$372.70	$418.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $279.05 / $279.05 / $284.25	Facility		$279.05	$279.05	$284.25
United Facility/Professional Facility Modifier Low / Median / High Price $414.00 / $666.00 / $6,216.00	Facility		$414.00	$666.00	$6,216.00