Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.12 / $184.67 / $240.37	Facility		$110.12	$184.67	$240.37
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $113.70 / $1,575.90	Facility		$55.00	$113.70	$1,575.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $96.76 / $170.29 / $212.20	Facility		$96.76	$170.29	$212.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $116.28 / $157.12 / $166.83	Facility		$116.28	$157.12	$166.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.70 / $113.70 / $113.79	Facility		$113.70	$113.70	$113.79
United Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $666.00 / $6,216.00	Facility		$190.00	$666.00	$6,216.00