Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $132.91 / $170.01 / $273.52	Facility		$132.91	$170.01	$273.52
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $132.72 / $225.00 / $445.07	Facility		$132.72	$225.00	$445.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $94.24 / $208.80 / $250.60	Facility		$94.24	$208.80	$250.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $141.96 / $186.92 / $196.31	Facility		$141.96	$186.92	$196.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $132.72 / $132.72 / $133.90	Facility		$132.72	$132.72	$133.90
United Facility/Professional Facility Modifier Low / Median / High Price $1,120.00 / $3,323.00 / $36,803.00	Facility		$1,120.00	$3,323.00	$36,803.00