Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $185.45 / $2,769.52 / $17,930.00	Facility		$185.45	$2,769.52	$17,930.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $140.30 / $1,300.00	Facility		$55.00	$140.30	$1,300.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $97.65 / $206.60 / $256.39	Facility		$97.65	$206.60	$256.39
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $147.97 / $195.97 / $205.69	Facility		$147.97	$195.97	$205.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.62 / $138.62 / $140.30	Facility		$138.62	$138.62	$140.30
United Facility/Professional Facility Modifier Low / Median / High Price $125.00 / $497.00 / $5,793.00	Facility		$125.00	$497.00	$5,793.00