Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.49 / $50.49 / $50.49	Facility		$50.49	$50.49	$50.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.49 / $55.53 / $69.98	Professional		$50.49	$55.53	$69.98
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $92.43 / $134.62 / $260.43	Facility		$92.43	$134.62	$260.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $50.00	Professional		$45.00	$50.00	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $20.97 / $20.97 / $72.00	Facility		$20.97	$20.97	$72.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $87.29 / $134.54 / $257.51	Facility		$87.29	$134.54	$257.51