Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.42 / $6,470.00 / $25,546.00	Facility		$794.42	$6,470.00	$25,546.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $19,066.50 / $51,832.47 / $51,832.47	Facility	50	$19,066.50	$51,832.47	$51,832.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $13,277.70 / $26,542.00 / $51,100.93	Facility		$13,277.70	$26,542.00	$51,100.93
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $27,262.73 / $40,071.05 / $77,521.71	Facility	50	$27,262.73	$40,071.05	$77,521.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,513.20 / $4,513.20 / $7,518.94	Facility		$4,513.20	$4,513.20	$7,518.94
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $790.07 / $1,392.52 / $16,087.19	Facility		$790.07	$1,392.52	$16,087.19
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $16,087.19 / $24,667.59 / $59,350.10	Facility	50	$16,087.19	$24,667.59	$59,350.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $898.33 / $1,211.81 / $1,259.71	Facility		$898.33	$1,211.81	$1,259.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $823.55 / $848.19 / $2,934.87	Facility		$823.55	$848.19	$2,934.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $17,322.84 / $26,698.76 / $51,100.93	Facility		$17,322.84	$26,698.76	$51,100.93
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $25,984.28 / $40,048.14 / $76,651.39	Facility	50	$25,984.28	$40,048.14	$76,651.39
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $4,686.00 / $20,708.00	Facility		$3,028.00	$4,686.00	$20,708.00