Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,604.38 / $5,132.00 / $22,024.00	Facility		$1,604.38	$5,132.00	$22,024.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,168.25 / $1,794.59 / $2,617.51	Facility	54	$1,168.25	$1,794.59	$2,617.51
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,688.62 / $18,220.34 / $35,644.43	Facility		$1,688.62	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $21,726.84 / $27,950.76 / $54,073.73	Facility	50	$21,726.84	$27,950.76	$54,073.73
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,205.15 / $3,947.29 / $3,947.29	Facility	54	$1,205.15	$3,947.29	$3,947.29
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $172.16 / $563.90 / $563.90	Facility	AS	$172.16	$563.90	$563.90
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 $1,190.50 / $2,430.46 / $3,386.83	Facility		$1,190.50	$2,430.46	$3,386.83
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $22,867.07 / $23,825.60 / $57,324.29	Facility	50	$22,867.07	$23,825.60	$57,324.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,719.49 / $2,377.83 / $2,475.65	Facility		$1,719.49	$2,377.83	$2,475.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,646.66 / $1,646.66 / $1,688.62	Facility		$1,646.66	$1,646.66	$1,688.62
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
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $21,350.01 / $27,950.76 / $53,466.65	Facility	50	$21,350.01	$27,950.76	$53,466.65
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $4,016.00 / $16,315.00	Facility		$2,912.00	$4,016.00	$16,315.00