Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $589.72 / $1,035.15 / $1,035.15	Facility		$589.72	$1,035.15	$1,035.15
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $429.80 / $429.80 / $429.80	Professional		$429.80	$429.80	$429.80
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 $136.22 / $168.72 / $223.44	Facility		$136.22	$168.72	$223.44