Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,837.00 / $14,464.32 / $29,300.00	Facility		$4,837.00	$14,464.32	$29,300.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13,753.37 / $13,753.37 / $13,753.37	Professional		$13,753.37	$13,753.37	$13,753.37
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $8,671.16 / $11,997.85 / $24,013.08	Facility		$8,671.16	$11,997.85	$24,013.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,939.01 / $1,939.01 / $1,939.01	Professional		$1,939.01	$1,939.01	$1,939.01
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,750.50 / $30,114.32 / $75,492.08	Facility		$3,750.50	$30,114.32	$75,492.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,945.00 / $9,526.00 / $79,999.20	Facility		$5,945.00	$9,526.00	$79,999.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,520.76 / $11,584.92 / $24,013.08	Facility		$8,520.76	$11,584.92	$24,013.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,939.01 / $1,939.01 / $1,939.01	Professional		$1,939.01	$1,939.01	$1,939.01
United Facility/Professional Facility Modifier Low / Median / High Price $2,245.00 / $6,594.00 / $12,835.00	Facility		$2,245.00	$6,594.00	$12,835.00