Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,310.19 / $15,947.00 / $30,542.85	Facility		$1,310.19	$15,947.00	$30,542.85
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $14,115.00 / $14,115.00 / $14,115.00	Facility	22	$14,115.00	$14,115.00	$14,115.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $489.00 / $658.68 / $1,005.80	Facility	52	$489.00	$658.68	$1,005.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,298.40 / $14,160.61 / $21,602.23	Facility		$3,298.40	$14,160.61	$21,602.23
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $7,396.23 / $12,302.24 / $12,302.24	Facility	52	$7,396.23	$12,302.24	$12,302.24
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $924.53 / $1,537.78 / $1,537.78	Facility	AS	$924.53	$1,537.78	$1,537.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,000.00 / $2,285.42 / $6,775.01	Facility		$2,000.00	$2,285.42	$6,775.01
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $793.87 / $1,587.02 / $6,197.13	Facility		$793.87	$1,587.02	$6,197.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,069.18 / $1,384.89 / $1,450.55	Facility		$1,069.18	$1,384.89	$1,450.55
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $973.95 / $2,010.99 / $3,875.03	Facility		$973.95	$2,010.99	$3,875.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,603.20 / $16,351.48 / $31,278.54	Facility		$10,603.20	$16,351.48	$31,278.54
United Facility/Professional Facility Modifier Low / Median / High Price $1,900.00 / $4,686.00 / $19,271.00	Facility		$1,900.00	$4,686.00	$19,271.00