Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.43 / $243.89 / $20,680.40	Facility		$104.43	$243.89	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $116.87 / $1,300.00	Facility		$55.00	$116.87	$1,300.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $102.91 / $177.16 / $223.64	Facility		$102.91	$177.16	$223.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $127.40 / $162.37 / $175.54	Facility		$127.40	$162.37	$175.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $116.87 / $116.87 / $119.73	Facility		$116.87	$116.87	$119.73
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