Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,060.57 / $1,060.57 / $1,060.57	Facility		$1,060.57	$1,060.57	$1,060.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $433.77 / $1,060.57 / $1,060.57	Professional		$433.77	$1,060.57	$1,060.57
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,517.00 / $1,517.00 / $1,517.00	Facility		$1,517.00	$1,517.00	$1,517.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $48.27 / $67.44 / $111.92	Professional		$48.27	$67.44	$111.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $50.00 / $75.00	Professional		$30.00	$50.00	$75.00
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 $1,517.00 / $1,517.00 / $1,517.00	Facility		$1,517.00	$1,517.00	$1,517.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $78.26 / $78.26 / $78.26	Professional		$78.26	$78.26	$78.26