Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,611.39 / $12,134.00 / $27,982.24	Facility		$1,611.39	$12,134.00	$27,982.24
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $14,115.00 / $14,115.00 / $38,695.30	Facility	50	$14,115.00	$14,115.00	$38,695.30
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,897.00 / $19,056.41 / $38,781.51	Facility		$5,897.00	$19,056.41	$38,781.51
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $20,860.50 / $30,410.72 / $58,832.76	Facility	50	$20,860.50	$30,410.72	$58,832.76
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $1,134.79 / $1,887.52 / $1,887.52	Facility	AS	$1,134.79	$1,887.52	$1,887.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,000.00 / $2,285.42 / $8,315.84	Facility		$2,000.00	$2,285.42	$8,315.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,405.05 / $2,822.77 / $7,292.72	Facility		$1,405.05	$2,822.77	$7,292.72
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $12,906.11 / $19,857.63 / $47,777.37	Facility	50	$12,906.11	$19,857.63	$47,777.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,847.79 / $2,498.46 / $2,632.43	Facility		$1,847.79	$2,498.46	$2,632.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,741.33 / $1,795.55 / $6,526.97	Facility		$1,741.33	$1,795.55	$6,526.97
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,146.66 / $20,262.22 / $38,781.51	Facility		$13,146.66	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $19,719.99 / $30,393.33 / $58,172.27	Facility	50	$19,719.99	$30,393.33	$58,172.27
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $5,547.00 / $19,271.00	Facility		$3,028.00	$5,547.00	$19,271.00