Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.99 / $40.99 / $40.99	Facility		$40.99	$40.99	$40.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.02 / $30.04 / $40.99	Professional		$23.02	$30.04	$40.99
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 $36.06 / $252.83 / $283.32	Professional		$36.06	$252.83	$283.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $39.56 / $77.29 / $4,686.56	Facility		$39.56	$77.29	$4,686.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.04 / $67.00 / $88.93	Professional		$35.04	$67.00	$88.93
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 $41.13 / $58.07 / $58.96	Facility		$41.13	$58.07	$58.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.97 / $58.97 / $58.97	Professional		$58.97	$58.97	$58.97