Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,124.24 / $5,132.00 / $22,024.00	Facility		$1,124.24	$5,132.00	$22,024.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $852.76 / $18,220.34 / $35,644.43	Facility		$852.76	$18,220.34	$35,644.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $765.00 / $870.49	Facility		$714.97	$765.00	$870.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $627.33 / $1,235.86 / $1,667.86	Facility		$627.33	$1,235.86	$1,667.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $908.00 / $1,192.97 / $1,250.22	Facility		$908.00	$1,192.97	$1,250.22
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $825.82 / $825.82 / $852.76	Facility		$825.82	$825.82	$852.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,233.34 / $18,633.84 / $35,644.43	Facility		$14,233.34	$18,633.84	$35,644.43
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $5,547.00 / $19,271.00	Facility		$3,028.00	$5,547.00	$19,271.00