Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $700.00 / $700.00 / $700.00	Facility		$700.00	$700.00	$700.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $700.00 / $700.00 / $700.00	Professional		$700.00	$700.00	$700.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $79.73 / $104.24 / $212.70	Facility		$79.73	$104.24	$212.70
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $73.08 / $73.08	Professional		$40.00	$73.08	$73.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $54.22 / $216.26 / $372.89	Facility		$54.22	$216.26	$372.89
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 $50.00 / $79.00 / $79,999.20	Facility		$50.00	$79.00	$79,999.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $73.00 / $102.05 / $212.70	Facility		$73.00	$102.05	$212.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $65.77 / $65.77 / $65.77	Professional		$65.77	$65.77	$65.77