Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $195.90 / $195.90 / $195.90	Facility		$195.90	$195.90	$195.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.94 / $168.20 / $195.90	Professional		$152.94	$168.20	$195.90
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $441.60 / $939.13 / $939.13	Facility		$441.60	$939.13	$939.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $312.00 / $1,053.42 / $1,535.03	Professional		$312.00	$1,053.42	$1,535.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $142.80 / $285.33 / $1,416.62	Facility		$142.80	$285.33	$1,416.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.36 / $272.62 / $406.47	Professional		$141.36	$272.62	$406.47
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 $231.38 / $338.47 / $352.42	Facility		$231.38	$338.47	$352.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $282.95 / $345.44 / $345.44	Professional		$282.95	$345.44	$345.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $118.00 / $118.00 / $118.00	Professional		$118.00	$118.00	$118.00