Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $436.69 / $2,323.00 / $17,100.00	Facility		$436.69	$2,323.00	$17,100.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $218.35 / $292.25 / $469.30	Facility	52	$218.35	$292.25	$469.30
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $87.34 / $116.90 / $187.72	Facility	53	$87.34	$116.90	$187.72
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,439.64 / $10,639.60 / $16,394.00	Facility		$1,439.64	$10,639.60	$16,394.00
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $4,850.47 / $8,067.84 / $8,067.84	Facility	52	$4,850.47	$8,067.84	$8,067.84
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $1,212.61 / $2,016.96 / $2,016.96	Facility	53	$1,212.61	$2,016.96	$2,016.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $4,443.08	Facility		$625.25	$761.81	$4,443.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $387.45 / $729.14 / $4,064.10	Facility		$387.45	$729.14	$4,064.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $510.58 / $617.88 / $659.28	Facility		$510.58	$617.88	$659.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $427.18 / $1,107.43 / $2,328.38	Facility		$427.18	$1,107.43	$2,328.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,037.75 / $10,846.90 / $20,760.75	Facility		$7,037.75	$10,846.90	$20,760.75
United Facility/Professional Facility Modifier Low / Median / High Price $1,100.00 / $2,038.00 / $10,522.00	Facility		$1,100.00	$2,038.00	$10,522.00