Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.06 / $106.83 / $111.53	Facility		$47.06	$106.83	$111.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.06 / $47.06 / $81.41	Professional		$47.06	$47.06	$81.41
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $10.80 / $100.00 / $100.00	Facility		$10.80	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $27.00 / $36.00 / $75.00	Professional		$27.00	$36.00	$75.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $0.80 / $0.80 / $1.20	Facility		$0.80	$0.80	$1.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $0.80 / $0.80 / $1.20	Professional		$0.80	$0.80	$1.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $76.50 / $93.50	Professional		$60.00	$76.50	$93.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,071.43 / $1,071.43 / $1,071.43	Facility		$1,071.43	$1,071.43	$1,071.43
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,071.43 / $1,071.43 / $1,071.43	Professional		$1,071.43	$1,071.43	$1,071.43