Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.85 / $55.85 / $55.85	Facility		$55.85	$55.85	$55.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.57 / $47.90 / $58.85	Professional		$32.57	$47.90	$58.85
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $204.42 / $204.42	Facility		$75.00	$204.42	$204.42
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $54.00 / $262.88 / $339.90	Professional		$54.00	$262.88	$339.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $51.77 / $97.53 / $699.54	Facility		$51.77	$97.53	$699.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.87 / $92.46 / $121.50	Professional		$47.87	$92.46	$121.50
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 $54.68 / $77.06 / $79.06	Facility		$54.68	$77.06	$79.06
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.08 / $115.08 / $115.08	Professional		$115.08	$115.08	$115.08