Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.53 / $54.53 / $54.53	Facility		$54.53	$54.53	$54.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.92 / $47.20 / $54.53	Professional		$35.92	$47.20	$54.53
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $441.60 / $885.11 / $885.11	Facility		$441.60	$885.11	$885.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $106.00 / $283.32 / $371.55	Professional		$106.00	$283.32	$371.55
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $54.60 / $102.33 / $2,059.66	Facility		$54.60	$102.33	$2,059.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.60 / $90.62 / $116.44	Professional		$54.60	$90.62	$116.44
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 $56.71 / $84.46 / $856.52	Facility		$56.71	$84.46	$856.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $161.69 / $197.39 / $197.39	Professional		$161.69	$197.39	$197.39