Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,906.46 / $11,500.00 / $12,000.00	Facility		$3,906.46	$11,500.00	$12,000.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,692.26 / $1,692.26 / $1,692.26	Professional		$1,692.26	$1,692.26	$1,692.26
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 $250.00 / $336.70 / $356.73	Facility		$250.00	$336.70	$356.73