Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $585.04 / $585.04 / $585.04	Facility		$585.04	$585.04	$585.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $585.04 / $585.04 / $603.50	Professional		$585.04	$585.04	$603.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,294.58 / $1,729.60 / $3,221.95	Facility		$1,294.58	$1,729.60	$3,221.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $653.54 / $1,645.00	Professional		$30.00	$653.54	$1,645.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $617.61 / $1,677.92 / $2,906.41	Facility		$617.61	$1,677.92	$2,906.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $7.61 / $7.61 / $7.61	Professional		$7.61	$7.61	$7.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $100.00 / $100.00	Professional		$50.00	$100.00	$100.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $888.00 / $1,422.00 / $79,999.20	Facility		$888.00	$1,422.00	$79,999.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,272.13 / $1,697.18 / $3,185.78	Facility		$1,272.13	$1,697.18	$3,185.78
United Facility/Professional Professional Modifier Low / Median / High Price $683.77 / $683.77 / $683.77	Professional		$683.77	$683.77	$683.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $249.72 / $249.72	Professional		$30.00	$249.72	$249.72