Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.75 / $48.75 / $48.75	Professional		$48.75	$48.75	$48.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $908.26 / $908.26 / $908.26	Facility		$908.26	$908.26	$908.26
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $65.78 / $97.79 / $901.00	Professional		$65.78	$97.79	$901.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $432.80 / $592.14 / $751.00	Professional		$432.80	$592.14	$751.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $450.50 / $450.50 / $450.50	Professional		$450.50	$450.50	$450.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $60.00 / $70.00	Professional		$30.00	$60.00	$70.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,617.99 / $3,642.41 / $3,762.71	Facility		$3,617.99	$3,642.41	$3,762.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $250.00 / $250.00	Professional		$250.00	$250.00	$250.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $69.58 / $69.58 / $69.58	Professional		$69.58	$69.58	$69.58