Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $90.80 / $94.80	Facility		$40.00	$90.80	$94.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $69.20	Professional		$40.00	$40.00	$69.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $381.85	Facility		$100.00	$100.00	$381.85
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $103.87 / $429.88 / $872.39	Professional		$103.87	$429.88	$872.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.72 / $139.72 / $139.72	Professional		$139.72	$139.72	$139.72
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 $122.86 / $122.86 / $79,999.20	Facility		$122.86	$122.86	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $122.86 / $122.86 / $122.86	Professional		$122.86	$122.86	$122.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $218.00 / $218.00 / $218.00	Professional		$218.00	$218.00	$218.00