Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,128.00 / $23,000.00	Facility		$1,733.00	$5,128.00	$23,000.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $43,937.27 / $90,281.73	Facility		$5,000.00	$43,937.27	$90,281.73
Asuris Northwest Health Facility/Professional Facility Modifier 62 Low / Median / High Price $1,121.08 / $3,722.09 / $3,722.09	Facility	62	$1,121.08	$3,722.09	$3,722.09
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $179.38 / $595.54 / $595.54	Facility	AS	$179.38	$595.54	$595.54
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 $1,204.97 / $2,439.40 / $3,485.47	Facility		$1,204.97	$2,439.40	$3,485.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,796.83 / $2,456.21 / $2,613.00	Facility		$1,796.83	$2,456.21	$2,613.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,718.23 / $1,782.30 / $24,524.93	Facility		$1,718.23	$1,782.30	$24,524.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $34,438.60 / $47,169.60 / $90,281.73	Facility		$34,438.60	$47,169.60	$90,281.73
United Facility/Professional Facility Modifier Low / Median / High Price $3,700.00 / $7,614.00 / $24,236.00	Facility		$3,700.00	$7,614.00	$24,236.00