Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $989.24 / $5,116.62 / $20,680.40	Facility		$989.24	$5,116.62	$20,680.40
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $494.62 / $773.76 / $1,128.56	Facility	52	$494.62	$773.76	$1,128.56
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $197.85 / $309.50 / $451.42	Facility	53	$197.85	$309.50	$451.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,047.79 / $9,664.93	Facility		$55.00	$1,047.79	$9,664.93
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $843.71 / $2,769.66 / $2,769.66	Facility	52	$843.71	$2,769.66	$2,769.66
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $210.93 / $692.42 / $692.42	Facility	53	$210.93	$692.42	$692.42
Asuris Northwest Health Facility/Professional Facility Modifier 62 Low / Median / High Price $659.15 / $2,163.80 / $2,163.80	Facility	62	$659.15	$2,163.80	$2,163.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $748.03 / $1,656.62 / $2,011.94	Facility		$748.03	$1,656.62	$2,011.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,125.01 / $1,451.81 / $1,555.74	Facility		$1,125.01	$1,451.81	$1,555.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,043.79 / $1,043.79 / $1,047.79	Facility		$1,043.79	$1,043.79	$1,047.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,250.01 / $1,250.01 / $1,333.34	Facility		$1,250.01	$1,250.01	$1,333.34
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $8,242.00 / $17,644.00	Facility		$2,912.00	$8,242.00	$17,644.00