Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.84 / $295.14 / $20,680.40	Facility		$131.84	$295.14	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $140.43 / $1,300.00	Facility		$55.00	$140.43	$1,300.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $97.96 / $218.22 / $265.02	Facility		$97.96	$218.22	$265.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $154.27 / $199.88 / $207.70	Facility		$154.27	$199.88	$207.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $140.43 / $140.43 / $141.66	Facility		$140.43	$140.43	$141.66
United Facility/Professional Facility Modifier Low / Median / High Price $497.00 / $1,078.00 / $6,216.00	Facility		$497.00	$1,078.00	$6,216.00