Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,409.21 / $11,500.00 / $26,542.00	Facility		$3,409.21	$11,500.00	$26,542.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,012.68 / $4,012.68 / $4,012.68	Professional		$4,012.68	$4,012.68	$4,012.68
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 $802.82 / $1,049.75 / $1,131.52	Facility		$802.82	$1,049.75	$1,131.52