Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $509.69 / $509.69 / $509.69	Facility		$509.69	$509.69	$509.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.08 / $500.98 / $509.69	Professional		$318.08	$500.98	$509.69
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $14,442.95 / $16,547.20 / $16,547.20	Facility		$14,442.95	$16,547.20	$16,547.20
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $911.00 / $2,436.69 / $3,154.80	Professional		$911.00	$2,436.69	$3,154.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $490.38 / $979.27 / $1,951.21	Facility		$490.38	$979.27	$1,951.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $467.47 / $916.31 / $1,177.27	Professional		$467.47	$916.31	$1,177.27
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 $593.79 / $694.62 / $724.27	Facility		$593.79	$694.62	$724.27
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $999.90 / $1,220.61 / $1,220.61	Professional		$999.90	$1,220.61	$1,220.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $687.00 / $687.00 / $687.00	Professional		$687.00	$687.00	$687.00