Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.86 / $30.90 / $42.33	Facility		$17.86	$30.90	$42.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.86 / $17.86 / $44.18	Professional		$17.86	$17.86	$44.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $28.09 / $85.00 / $100.00	Facility		$28.09	$85.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $18.39 / $18.91 / $46.22	Professional		$18.39	$18.91	$46.22
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $10.85 / $4,828.18 / $5,095.70	Facility		$10.85	$4,828.18	$5,095.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $10.85 / $4,828.18 / $5,095.70	Professional		$10.85	$4,828.18	$5,095.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.37 / $13.37 / $13.37	Professional		$13.37	$13.37	$13.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $18.55 / $18.55 / $79,999.20	Facility		$18.55	$18.55	$79,999.20
United Facility/Professional Professional Modifier Low / Median / High Price $21.01 / $21.01 / $21.01	Professional		$21.01	$21.01	$21.01