Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.58 / $28.58 / $28.58	Facility		$28.58	$28.58	$28.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.13 / $22.23 / $28.58	Professional		$17.13	$22.23	$28.58
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $441.60 / $885.11 / $885.11	Facility		$441.60	$885.11	$885.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $21.56 / $209.93 / $283.32	Professional		$21.56	$209.93	$283.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $19.88 / $42.33 / $4,686.56	Facility		$19.88	$42.33	$4,686.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $19.53 / $37.04 / $52.13	Professional		$19.53	$37.04	$52.13
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 $34.11 / $48.14 / $48.91	Facility		$34.11	$48.14	$48.91
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.09 / $88.09 / $88.09	Professional		$88.09	$88.09	$88.09