Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.69 / $64.69 / $64.69	Facility		$64.69	$64.69	$64.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $50.10 / $64.69	Professional		$37.20	$50.10	$64.69
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $78.98 / $256.32 / $256.32	Facility		$78.98	$256.32	$256.32
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $62.47 / $314.82 / $422.78	Professional		$62.47	$314.82	$422.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $50.84 / $103.51 / $699.54	Facility		$50.84	$103.51	$699.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.84 / $97.38 / $135.71	Professional		$50.84	$97.38	$135.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $64.66 / $96.93 / $98.49	Facility		$64.66	$96.93	$98.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.47 / $138.47 / $138.47	Professional		$138.47	$138.47	$138.47