Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,857.13 / $5,136.82 / $17,967.00	Facility		$1,857.13	$5,136.82	$17,967.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $928.57 / $1,601.33 / $2,064.96	Facility	52	$928.57	$1,601.33	$2,064.96
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,942.46 / $11,877.88	Facility		$55.00	$1,942.46	$11,877.88
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $11,173.25 / $11,173.25 / $20,358.83	Facility	50	$11,173.25	$11,173.25	$20,358.83
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,627.92 / $5,298.36 / $5,298.36	Facility	52	$1,627.92	$5,298.36	$5,298.36
Asuris Northwest Health Facility/Professional Facility Modifier 62 Low / Median / High Price $1,271.81 / $4,139.34 / $4,139.34	Facility	62	$1,271.81	$4,139.34	$4,139.34
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $203.49 / $662.30 / $662.30	Facility	AS	$203.49	$662.30	$662.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,747.67 / $2,893.06 / $3,625.89	Facility		$1,747.67	$2,893.06	$3,625.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,026.66 / $2,783.85 / $2,921.20	Facility		$2,026.66	$2,783.85	$2,921.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,239.50 / $1,942.46 / $1,992.52	Facility		$1,239.50	$1,942.46	$1,992.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,572.55 / $13,572.55 / $24,898.13	Facility		$13,572.55	$13,572.55	$24,898.13
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $20,358.83 / $20,358.83 / $37,347.19	Facility	50	$20,358.83	$20,358.83	$37,347.19
United Facility/Professional Facility Modifier Low / Median / High Price $1,550.00 / $2,431.00 / $11,261.00	Facility		$1,550.00	$2,431.00	$11,261.00