Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.00 / $45.40 / $47.40	Facility		$20.00	$45.40	$47.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $20.00 / $34.60	Professional		$20.00	$20.00	$34.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $90.00 / $100.00	Facility		$80.00	$90.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4.00 / $74.69 / $76.18	Professional		$4.00	$74.69	$76.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3.60 / $3.60 / $3.60	Professional		$3.60	$3.60	$3.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.14 / $27.07 / $30.00	Professional		$22.14	$27.07	$30.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $193.14 / $193.14 / $79,999.20	Facility		$193.14	$193.14	$79,999.20
United Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $19.50 / $19.50	Professional		$19.50	$19.50	$19.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $4.00 / $4.00 / $39.10	Professional		$4.00	$4.00	$39.10