Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,454.00 / $1,454.00	Facility		$55.00	$1,454.00	$1,454.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $231.88 / $455.63 / $465.40	Professional		$231.88	$455.63	$465.40
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 $79.80 / $166.44 / $196.31	Facility		$79.80	$166.44	$196.31