Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.86 / $128.86 / $1,382.47	Facility		$62.86	$128.86	$1,382.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $62.15 / $166.70 / $5,294.00	Facility		$62.15	$166.70	$5,294.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $72.14 / $128.65 / $366.27	Facility		$72.14	$128.65	$366.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $74.80 / $107.55 / $282.89	Facility		$74.80	$107.55	$282.89
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.15 / $62.15 / $166.70	Facility		$62.15	$62.15	$166.70
United Facility/Professional Facility Modifier Low / Median / High Price $497.00 / $1,078.00 / $6,216.00	Facility		$497.00	$1,078.00	$6,216.00