Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $410.40 / $410.40 / $410.40	Facility		$410.40	$410.40	$410.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.27 / $339.27 / $438.82	Professional		$85.27	$339.27	$438.82
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,001.28 / $3,113.61 / $3,113.61	Facility		$1,001.28	$3,113.61	$3,113.61
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $417.78 / $3,202.34 / $5,095.43	Professional		$417.78	$3,202.34	$5,095.43
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $105.67 / $154.86 / $1,030.11	Facility		$105.67	$154.86	$1,030.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $113.41 / $167.45 / $1,055.86	Professional		$113.41	$167.45	$1,055.86
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 $958.19 / $1,120.96 / $1,169.82	Facility		$958.19	$1,120.96	$1,169.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.39 / $394.79 / $394.79	Professional		$323.39	$394.79	$394.79