Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $284.00 / $945.34 / $10,122.46	Facility		$284.00	$945.34	$10,122.46
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $56.80 / $142.31 / $356.06	Facility	53	$56.80	$142.31	$356.06
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $625.79 / $2,532.58 / $12,000.00	Facility		$625.79	$2,532.58	$12,000.00
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $78.52 / $140.78 / $140.78	Facility	53	$78.52	$140.78	$140.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $466.83 / $568.48 / $1,159.36	Facility		$466.83	$568.48	$1,159.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $225.01 / $449.54 / $937.66	Facility		$225.01	$449.54	$937.66
Kaiser Permanente Facility/Professional Facility Modifier 53 Low / Median / High Price $102.48 / $198.42 / $418.33	Facility	53	$102.48	$198.42	$418.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $311.20 / $616.52 / $651.95	Facility		$311.20	$616.52	$651.95
Pacific Source Facility/Professional Facility Modifier 53 Low / Median / High Price $259.35 / $317.58 / $646.00	Facility	53	$259.35	$317.58	$646.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $422.54 / $435.33 / $671.06	Facility		$422.54	$435.33	$671.06
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,889.92 / $2,590.05 / $4,954.47	Facility		$1,889.92	$2,590.05	$4,954.47
Regence BlueShield Facility/Professional Facility Modifier 53 Low / Median / High Price $1,539.68 / $1,539.68 / $2,392.77	Facility	53	$1,539.68	$1,539.68	$2,392.77
United Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $1,120.00 / $6,857.00	Facility		$650.00	$1,120.00	$6,857.00