Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $872.30 / $4,037.71 / $10,589.38	Facility		$872.30	$4,037.71	$10,589.38
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $510.38 / $753.70 / $1,014.32	Facility	54	$510.38	$753.70	$1,014.32
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,708.27 / $4,554.63 / $11,500.00	Facility		$1,708.27	$4,554.63	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $854.11 / $1,534.41 / $1,534.41	Facility	54	$854.11	$1,534.41	$1,534.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $1,985.59	Facility		$625.25	$761.81	$1,985.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $497.55 / $984.20 / $1,490.07	Facility		$497.55	$984.20	$1,490.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $713.67 / $986.91 / $1,081.38	Facility		$713.67	$986.91	$1,081.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.44 / $707.59 / $1,613.81	Facility		$537.44	$707.59	$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