Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.37 / $239.37 / $239.37	Facility		$239.37	$239.37	$239.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.37 / $239.37 / $1,401.39	Professional		$239.37	$239.37	$1,401.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $448.80 / $448.80 / $448.80	Professional		$448.80	$448.80	$448.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20