Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,751.72 / $1,751.72 / $2,550.00	Professional		$1,751.72	$1,751.72	$2,550.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $81.89 / $100.00 / $100.00	Facility		$81.89	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,844.50 / $1,844.50 / $2,236.00	Professional		$1,844.50	$1,844.50	$2,236.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $783.67 / $783.67 / $783.67	Professional		$783.67	$783.67	$783.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $76.50 / $93.50	Professional		$60.00	$76.50	$93.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,577.64 / $4,577.64 / $4,577.64	Facility		$4,577.64	$4,577.64	$4,577.64
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,577.64 / $4,577.64 / $4,577.64	Professional		$4,577.64	$4,577.64	$4,577.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,031.05 / $2,031.05 / $2,031.05	Professional		$2,031.05	$2,031.05	$2,031.05