Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.90 / $126.90 / $126.90	Facility		$126.90	$126.90	$126.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.74 / $104.88 / $126.90	Professional		$93.74	$104.88	$126.90
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $193.80 / $1,281.80 / $1,281.80	Facility		$193.80	$1,281.80	$1,281.80
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $204.00 / $677.88 / $986.18	Professional		$204.00	$677.88	$986.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $126.62 / $205.72 / $3,065.20	Facility		$126.62	$205.72	$3,065.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $126.62 / $201.55 / $267.20	Professional		$126.62	$201.55	$267.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $50.00	Professional		$45.00	$50.00	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $185.49 / $216.93 / $1,330.00	Facility		$185.49	$216.93	$1,330.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.64 / $242.49 / $242.49	Professional		$198.64	$242.49	$242.49