Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,306.53 / $9,305.92 / $58,483.23	Facility		$2,306.53	$9,305.92	$58,483.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,499.33 / $51,640.59 / $101,024.36	Facility		$2,499.33	$51,640.59	$101,024.36
Asuris Northwest Health Facility/Professional Facility Modifier 62 Low / Median / High Price $1,570.84 / $5,209.43 / $5,209.43	Facility	62	$1,570.84	$5,209.43	$5,209.43
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $251.33 / $833.51 / $833.51	Facility	AS	$251.33	$833.51	$833.51
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 $2,016.00 / $3,727.18 / $12,593.29	Facility		$2,016.00	$3,727.18	$12,593.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,614.36 / $3,469.93 / $3,725.72	Facility		$2,614.36	$3,469.93	$3,725.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,486.52 / $2,499.33 / $23,065.03	Facility		$2,486.52	$2,499.33	$23,065.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $41,427.18 / $53,714.89 / $101,024.36	Facility		$41,427.18	$53,714.89	$101,024.36
United Facility/Professional Facility Modifier Low / Median / High Price $3,960.00 / $9,790.00 / $40,670.00	Facility		$3,960.00	$9,790.00	$40,670.00