Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,125.00 / $14,809.00 / $28,651.10	Facility		$1,125.00	$14,809.00	$28,651.10
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $17,165.00 / $17,165.00 / $17,165.00	Facility	22	$17,165.00	$17,165.00	$17,165.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,358.86 / $18,201.00 / $39,868.69	Facility	50	$6,358.86	$18,201.00	$39,868.69
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $9,886.41 / $16,351.48 / $31,278.54	Facility		$9,886.41	$16,351.48	$31,278.54
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $16,820.81 / $24,527.22 / $47,450.52	Facility	50	$16,820.81	$24,527.22	$47,450.52
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 $4,066.66 / $4,066.66 / $6,775.01	Facility		$4,066.66	$4,066.66	$6,775.01
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $811.86 / $1,436.83 / $12,028.17	Facility		$811.86	$1,436.83	$12,028.17
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $12,028.17 / $15,969.29 / $38,422.04	Facility	50	$12,028.17	$15,969.29	$38,422.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $927.11 / $1,240.83 / $1,316.55	Facility		$927.11	$1,240.83	$1,316.55
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $877.91 / $898.01 / $2,429.53	Facility		$877.91	$898.01	$2,429.53
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,603.20 / $16,342.14 / $31,278.54	Facility		$10,603.20	$16,342.14	$31,278.54
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $15,904.80 / $24,513.21 / $46,917.81	Facility	50	$15,904.80	$24,513.21	$46,917.81
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $4,686.00 / $20,708.00	Facility		$3,028.00	$4,686.00	$20,708.00