Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,401.14 / $5,128.00 / $20,680.40	Facility		$1,401.14	$5,128.00	$20,680.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,044.61 / $8,490.57 / $17,279.07	Facility		$1,044.61	$8,490.57	$17,279.07
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $428.90 / $757.42 / $757.42	Facility	AS	$428.90	$757.42	$757.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,064.50 / $1,716.50 / $8,977.36	Facility		$1,064.50	$1,716.50	$8,977.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,109.52 / $1,502.30 / $1,568.08	Facility		$1,109.52	$1,502.30	$1,568.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,044.61 / $1,044.61 / $1,068.47	Facility		$1,044.61	$1,044.61	$1,068.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,255.42 / $9,027.82 / $17,279.07	Facility		$6,255.42	$9,027.82	$17,279.07
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $6,594.00 / $12,835.00	Facility		$2,155.00	$6,594.00	$12,835.00