Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,050.58 / $16,584.88 / $58,612.67	Facility		$2,050.58	$16,584.88	$58,612.67
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $940.64 / $1,305.05 / $2,069.96	Facility	52	$940.64	$1,305.05	$2,069.96
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $27,419.55 / $55,801.25	Facility		$2,800.00	$27,419.55	$55,801.25
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $9,536.12 / $16,840.24 / $16,840.24	Facility	52	$9,536.12	$16,840.24	$16,840.24
Asuris Northwest Health Facility/Professional Facility Modifier 62 Low / Median / High Price $7,450.10 / $13,156.44 / $13,156.44	Facility	62	$7,450.10	$13,156.44	$13,156.44
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $1,192.02 / $2,105.03 / $2,105.03	Facility	AS	$1,192.02	$2,105.03	$2,105.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,044.26 / $3,479.80 / $27,723.28	Facility		$2,044.26	$3,479.80	$27,723.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,954.15 / $2,380.51 / $3,301.76	Facility		$1,954.15	$2,380.51	$3,301.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,623.72 / $1,623.72 / $1,904.41	Facility		$1,623.72	$1,623.72	$1,904.41
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $21,758.63 / $29,154.55 / $55,801.25	Facility		$21,758.63	$29,154.55	$55,801.25
United Facility/Professional Facility Modifier Low / Median / High Price $3,340.00 / $8,600.00 / $26,100.00	Facility		$3,340.00	$8,600.00	$26,100.00