Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.46 / $39.46 / $39.46	Facility		$39.46	$39.46	$39.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.58 / $32.64 / $39.46	Professional		$28.58	$32.64	$39.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $183.45 / $183.45	Facility		$75.00	$183.45	$183.45
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $62.00 / $209.82 / $297.30	Professional		$62.00	$209.82	$297.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $30.97 / $62.36 / $79.17	Facility		$30.97	$62.36	$79.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.34 / $62.36 / $82.62	Professional		$37.34	$62.36	$82.62
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 $44.88 / $66.19 / $68.34	Facility		$44.88	$66.19	$68.34
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.38 / $71.25 / $71.25	Professional		$58.38	$71.25	$71.25