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 $90.00 / $100.00 / $100.00	Facility		$90.00	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $12.46 / $22.50 / $51.35	Professional		$12.46	$22.50	$51.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.91 / $28.91 / $28.91	Professional		$28.91	$28.91	$28.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.20 / $19.81 / $19.81	Professional		$16.20	$19.81	$19.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $137.63 / $137.63 / $79,999.20	Facility		$137.63	$137.63	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $137.63 / $137.63 / $137.63	Professional		$137.63	$137.63	$137.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $12.46 / $12.46 / $29.55	Professional		$12.46	$12.46	$29.55