Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.10 / $17.10 / $17.10	Facility		$17.10	$17.10	$17.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.10 / $17.10 / $17.10	Professional		$17.10	$17.10	$17.10
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $134.28 / $172.78 / $334.26	Facility		$134.28	$172.78	$334.26
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $74.91 / $143.61	Professional		$30.00	$74.91	$143.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $66.45 / $162.13 / $338.57	Facility		$66.45	$162.13	$338.57
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 $92.00 / $148.00 / $79,999.20	Facility		$92.00	$148.00	$79,999.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $131.07 / $172.78 / $330.50	Facility		$131.07	$172.78	$330.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00