Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.37 / $26.79 / $30.67	Professional		$20.37	$26.79	$30.67
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 $41.00 / $171.75 / $283.32	Professional		$41.00	$171.75	$283.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $25.46 / $46.23 / $2,585.36	Facility		$25.46	$46.23	$2,585.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.46 / $40.65 / $60.88	Professional		$25.46	$40.65	$60.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $80.00	Professional		$45.00	$50.00	$80.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $32.45 / $38.97 / $39.53	Facility		$32.45	$38.97	$39.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.62 / $55.62 / $55.62	Professional		$55.62	$55.62	$55.62