Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.20 / $62.55 / $187.63	Facility		$29.20	$62.55	$187.63
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $133.15 / $763.38 / $1,701.50	Facility		$133.15	$763.38	$1,701.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $21.59 / $55.33 / $174.33	Facility		$21.59	$55.33	$174.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $53.27 / $130.35 / $145.38	Facility		$53.27	$130.35	$145.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $92.87 / $92.87 / $99.17	Facility		$92.87	$92.87	$99.17
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $531.22 / $869.76 / $1,701.50	Facility		$531.22	$869.76	$1,701.50