Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $155.97 / $2,769.52 / $18,711.00	Facility		$155.97	$2,769.52	$18,711.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $117.78 / $1,300.00	Facility		$55.00	$117.78	$1,300.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $103.73 / $177.86 / $224.52	Facility		$103.73	$177.86	$224.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $127.40 / $163.04 / $176.21	Facility		$127.40	$163.04	$176.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.78 / $117.78 / $120.19	Facility		$117.78	$117.78	$120.19
United Facility/Professional Facility Modifier Low / Median / High Price $703.00 / $2,446.00 / $36,803.00	Facility		$703.00	$2,446.00	$36,803.00