Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $172.95 / $521.00 / $13,750.00	Facility		$172.95	$521.00	$13,750.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $119.43 / $174.46 / $232.97	Facility	54	$119.43	$174.46	$232.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $161.22 / $626.41 / $1,278.36	Facility		$161.22	$626.41	$1,278.36
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $170.91 / $306.24 / $306.24	Facility	54	$170.91	$306.24	$306.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $182.34 / $182.34 / $182.34	Facility		$182.34	$182.34	$182.34
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $102.34 / $178.59 / $295.29	Facility		$102.34	$178.59	$295.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $155.82 / $224.45 / $258.62	Facility		$155.82	$224.45	$258.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.69 / $165.35 / $176.40	Facility		$53.69	$165.35	$176.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $433.36 / $667.91 / $1,278.36	Facility		$433.36	$667.91	$1,278.36
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $546.00 / $5,793.00	Facility		$157.00	$546.00	$5,793.00