Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.00 / $56.75 / $59.25	Facility		$25.00	$56.75	$59.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $25.00 / $25.00	Professional		$25.00	$25.00	$25.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $23.56 / $90.00 / $100.00	Facility		$23.56	$90.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $28.48 / $78.54	Professional		$0.60	$28.48	$78.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.74 / $32.74 / $32.74	Facility		$32.74	$32.74	$32.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.90 / $23.90 / $32.74	Professional		$23.90	$23.90	$32.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $76.50 / $93.50	Professional		$50.00	$76.50	$93.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $39.29 / $39.29 / $39.29	Facility		$39.29	$39.29	$39.29
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $39.29 / $39.29 / $39.29	Professional		$39.29	$39.29	$39.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.80 / $23.80 / $23.80	Professional		$23.80	$23.80	$23.80