Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $170.25 / $177.75	Facility		$75.00	$170.25	$177.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $129.75	Professional		$75.00	$75.00	$129.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $146.57	Facility		$100.00	$100.00	$146.57
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $51.92 / $188.44 / $655.94	Professional		$51.92	$188.44	$655.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.27 / $98.27 / $98.27	Professional		$98.27	$98.27	$98.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Professional		$85.00	$85.00	$85.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $147.43 / $147.43 / $79,999.20	Facility		$147.43	$147.43	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $147.43 / $147.43 / $147.43	Professional		$147.43	$147.43	$147.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $187.00 / $187.00 / $187.00	Professional		$187.00	$187.00	$187.00