Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $3,930.50	Facility		$55.00	$55.00	$3,930.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $403.00 / $636.54 / $636.54	Professional		$403.00	$636.54	$636.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $107.16 / $224.58 / $273.36	Facility		$107.16	$224.58	$273.36