Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.25 / $123.25 / $6,651.93	Facility		$123.25	$123.25	$6,651.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.00 / $123.25 / $123.25	Professional		$116.00	$123.25	$123.25
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $57.78 / $123.25 / $210.25	Facility		$57.78	$123.25	$210.25
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $137.75 / $319.00 / $319.00	Professional		$137.75	$319.00	$319.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.18 / $66.45 / $160.13	Facility		$49.18	$66.45	$160.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $45.00 / $45.00	Professional		$45.00	$45.00	$45.00