Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.16 / $199.16 / $199.16	Facility		$199.16	$199.16	$199.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.16 / $1,000.00 / $1,500.00	Professional		$199.16	$1,000.00	$1,500.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,500.00 / $3,890.01 / $3,890.01	Facility		$2,500.00	$3,890.01	$3,890.01
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $522.00 / $1,405.52 / $4,787.60	Professional		$522.00	$1,405.52	$4,787.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $65.00	Professional		$50.00	$50.00	$65.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,500.00 / $2,500.00 / $2,500.00	Facility		$2,500.00	$2,500.00	$2,500.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,787.60 / $4,787.60 / $4,787.60	Professional		$4,787.60	$4,787.60	$4,787.60