Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $453.77 / $3,810.00 / $18,711.00	Facility		$453.77	$3,810.00	$18,711.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $170.41 / $228.12 / $366.16	Facility	52	$170.41	$228.12	$366.16
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $68.16 / $91.25 / $146.46	Facility	53	$68.16	$91.25	$146.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $3,133.60 / $4,418.06	Facility		$55.00	$3,133.60	$4,418.06
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,636.71 / $2,722.36 / $2,722.36	Facility	52	$1,636.71	$2,722.36	$2,722.36
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $409.18 / $680.59 / $680.59	Facility	53	$409.18	$680.59	$680.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $870.49 / $1,499.24	Facility		$500.00	$870.49	$1,499.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $307.44 / $611.52 / $2,882.99	Facility		$307.44	$611.52	$2,882.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $371.42 / $480.78 / $501.16	Facility		$371.42	$480.78	$501.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $335.22 / $420.93 / $874.44	Facility		$335.22	$420.93	$874.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,298.89 / $3,344.18 / $6,397.05	Facility		$2,298.89	$3,344.18	$6,397.05
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