Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $160.18 / $2,812.16 / $18,711.00	Facility		$160.18	$2,812.16	$18,711.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $115.52 / $1,399.00	Facility		$55.00	$115.52	$1,399.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $104.40 / $128.50 / $215.91	Facility		$104.40	$128.50	$215.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $125.93 / $170.85 / $174.20	Facility		$125.93	$170.85	$174.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $115.52 / $115.52 / $118.82	Facility		$115.52	$115.52	$118.82
United Facility/Professional Facility Modifier Low / Median / High Price $112.00 / $497.00 / $5,793.00	Facility		$112.00	$497.00	$5,793.00