Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $767.89 / $2,064.40 / $12,214.00	Facility		$767.89	$2,064.40	$12,214.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $440.55 / $718.87 / $8,464.33	Facility	54	$440.55	$718.87	$8,464.33
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,160.88 / $4,554.63 / $11,500.00	Facility		$1,160.88	$4,554.63	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $753.18 / $1,347.91 / $1,347.91	Facility	54	$753.18	$1,347.91	$1,347.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $466.83 / $568.48 / $1,985.59	Facility		$466.83	$568.48	$1,985.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $420.48 / $828.55 / $1,449.37	Facility		$420.48	$828.55	$1,449.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $581.55 / $830.80 / $942.02	Facility		$581.55	$830.80	$942.02
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.44 / $609.29 / $1,613.81	Facility		$537.44	$609.29	$1,613.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,953.48 / $4,552.03 / $8,712.50	Facility		$2,953.48	$4,552.03	$8,712.50
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $546.00 / $5,793.00	Facility		$157.00	$546.00	$5,793.00