Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $753.40 / $2,715.99 / $17,930.00	Facility		$753.40	$2,715.99	$17,930.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $376.70 / $564.17 / $822.88	Facility	52	$376.70	$564.17	$822.88
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $565.04 / $846.27 / $1,234.32	Facility	54	$565.04	$846.27	$1,234.32
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,701.16 / $4,730.13 / $11,500.00	Facility		$2,701.16	$4,730.13	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,167.65 / $3,605.48 / $3,605.48	Facility	52	$2,167.65	$3,605.48	$3,605.48
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,896.69 / $3,154.80 / $3,154.80	Facility	54	$1,896.69	$3,154.80	$3,154.80
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 $619.21 / $1,231.35 / $1,819.68	Facility		$619.21	$1,231.35	$1,819.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $818.30 / $1,117.56 / $1,191.93	Facility		$818.30	$1,117.56	$1,191.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.44 / $790.94 / $1,613.81	Facility		$537.44	$790.94	$1,613.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,024.21 / $4,552.03 / $8,712.50	Facility		$3,024.21	$4,552.03	$8,712.50
United Facility/Professional Facility Modifier Low / Median / High Price $702.00 / $1,436.00 / $6,857.00	Facility		$702.00	$1,436.00	$6,857.00