Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,374.87 / $5,390.96 / $5,628.44	Facility		$2,374.87	$5,390.96	$5,628.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,374.87 / $2,374.87 / $2,497.23	Professional		$2,374.87	$2,374.87	$2,497.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $205.38	Facility		$100.00	$100.00	$205.38
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $155.88 / $3,371.10 / $3,371.10	Professional		$155.88	$3,371.10	$3,371.10
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 $45.00 / $50.00 / $75.00	Professional		$45.00	$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
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.53 / $109.53 / $109.53	Professional		$109.53	$109.53	$109.53