Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $11.35 / $11.85	Facility		$5.00	$11.35	$11.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $5.00 / $6.66	Professional		$5.00	$5.00	$6.66
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $273.83 / $273.83	Facility		$100.00	$273.83	$273.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3.10 / $5.20 / $100.00	Professional		$3.10	$5.20	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4.12 / $4.12 / $4.12	Facility		$4.12	$4.12	$4.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3.50 / $3.50 / $4.12	Professional		$3.50	$3.50	$4.12
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 $5.33 / $5.33 / $5.33	Facility		$5.33	$5.33	$5.33
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $5.33 / $5.33 / $5.33	Professional		$5.33	$5.33	$5.33
United Facility/Professional Professional Modifier Low / Median / High Price $0.24 / $4.41 / $4.41	Professional		$0.24	$4.41	$4.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3.83 / $3.83 / $3.83	Professional		$3.83	$3.83	$3.83