Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.75 / $83.75 / $83.75	Facility		$83.75	$83.75	$83.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.69 / $69.31 / $83.75	Professional		$60.69	$69.31	$83.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $131.82 / $410.31 / $410.31	Facility		$131.82	$410.31	$410.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $113.85 / $621.45 / $670.95	Professional		$113.85	$621.45	$670.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $74.69 / $109.62 / $166.56	Facility		$74.69	$109.62	$166.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.68 / $115.77 / $169.47	Professional		$75.68	$115.77	$169.47
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 $100.98 / $147.63 / $154.10	Facility		$100.98	$147.63	$154.10
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.26 / $113.85 / $113.85	Professional		$93.26	$113.85	$113.85