Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,004.12 / $5,128.00 / $21,917.86	Facility		$1,004.12	$5,128.00	$21,917.86
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $755.88 / $18,220.34 / $35,644.43	Facility		$755.88	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $76.80 / $252.36 / $252.36	Facility	AS	$76.80	$252.36	$252.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $765.00 / $870.49 / $870.49	Facility		$765.00	$870.49	$870.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $519.75 / $1,076.24 / $1,484.93	Facility		$519.75	$1,076.24	$1,484.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $760.93 / $1,041.18 / $1,108.18	Facility		$760.93	$1,041.18	$1,108.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $731.14 / $731.14 / $755.88	Facility		$731.14	$731.14	$755.88
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