Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,091.63 / $5,132.00 / $22,024.00	Facility		$1,091.63	$5,132.00	$22,024.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,925.70 / $9,124.02 / $20,178.18	Facility		$4,925.70	$9,124.02	$20,178.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,005.16 / $1,223.70 / $3,302.92	Facility		$1,005.16	$1,223.70	$3,302.92
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $564.16 / $1,210.64 / $2,896.56	Facility		$564.16	$1,210.64	$2,896.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $787.80 / $1,101.02 / $1,185.90	Facility		$787.80	$1,101.02	$1,185.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $776.90 / $803.50 / $2,412.73	Facility		$776.90	$803.50	$2,412.73
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,812.14 / $9,118.81 / $17,453.22	Facility		$6,812.14	$9,118.81	$17,453.22
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $4,016.00 / $16,315.00	Facility		$2,912.00	$4,016.00	$16,315.00