Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,041.76 / $3,616.95 / $3,616.95	Facility		$2,041.76	$3,616.95	$3,616.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $801.85 / $850.15 / $850.15	Professional		$801.85	$850.15	$850.15
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 $259.20 / $345.18 / $372.64	Facility		$259.20	$345.18	$372.64