Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,628.31 / $11,171.21 / $25,815.32	Facility		$1,628.31	$11,171.21	$25,815.32
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,528.21 / $26,091.73 / $49,939.07	Facility		$1,528.21	$26,091.73	$49,939.07
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $28,001.01 / $39,159.98 / $75,759.14	Facility	50	$28,001.01	$39,159.98	$75,759.14
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $1,544.92 / $2,569.69 / $2,569.69	Facility	AS	$1,544.92	$2,569.69	$2,569.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,795.54 / $6,795.54 / $11,321.29	Facility		$6,795.54	$6,795.54	$11,321.29
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,565.18 / $2,877.40 / $11,682.66	Facility		$1,565.18	$2,877.40	$11,682.66
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $11,682.66 / $28,342.47 / $68,191.84	Facility	50	$11,682.66	$28,342.47	$68,191.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,820.56 / $2,236.02 / $2,536.40	Facility		$1,820.56	$2,236.02	$2,536.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,528.21 / $1,689.69 / $4,273.27	Facility		$1,528.21	$1,689.69	$4,273.27
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $16,928.99 / $26,091.73 / $49,939.07	Facility		$16,928.99	$26,091.73	$49,939.07
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $25,393.49 / $39,137.60 / $74,908.61	Facility	50	$25,393.49	$39,137.60	$74,908.61
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $3,509.00 / $17,644.00	Facility		$2,912.00	$3,509.00	$17,644.00