Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $626.32 / $5,128.00 / $18,800.00	Facility		$626.32	$5,128.00	$18,800.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $466.14 / $10,460.45 / $21,287.95	Facility		$466.14	$10,460.45	$21,287.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $494.67 / $868.25 / $8,567.43	Facility		$494.67	$868.25	$8,567.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $490.31 / $659.67 / $699.72	Facility		$490.31	$659.67	$699.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $466.14 / $466.14 / $468.88	Facility		$466.14	$466.14	$468.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,216.46 / $10,881.75 / $21,287.95	Facility		$7,216.46	$10,881.75	$21,287.95
United Facility/Professional Facility Modifier Low / Median / High Price $7,198.00 / $13,016.24 / $25,046.84	Facility		$7,198.00	$13,016.24	$25,046.84