Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $640.00 / $640.00 / $640.00	Facility		$640.00	$640.00	$640.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $640.00 / $640.00 / $1,820.00	Professional		$640.00	$640.00	$1,820.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $361.18 / $392.70 / $701.11	Professional		$361.18	$392.70	$701.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $12.82 / $12.82 / $12.82	Professional		$12.82	$12.82	$12.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Professional		$50.00	$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 $6.26 / $6.26 / $6.26	Professional		$6.26	$6.26	$6.26