Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,500.00 / $12,214.00 / $27,982.24	Facility		$4,500.00	$12,214.00	$27,982.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,420.00 / $1,420.00 / $27,982.24	Professional		$1,420.00	$1,420.00	$27,982.24
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $83.30 / $113.65 / $219.86	Facility		$83.30	$113.65	$219.86
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $34.57 / $107.93 / $259.68	Facility		$34.57	$107.93	$259.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Professional		$50.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $61.00 / $97.00 / $79,999.20	Facility		$61.00	$97.00	$79,999.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $82.93 / $113.65 / $217.40	Facility		$82.93	$113.65	$217.40