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 $394.00 / $425.14 / $425.14	Professional		$394.00	$425.14	$425.14
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 $126.21 / $170.30 / $186.12	Facility		$126.21	$170.30	$186.12