Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.28 / $63.28 / $69.29	Facility		$63.28	$63.28	$69.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.28 / $69.29 / $72.38	Professional		$63.28	$69.29	$72.38
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $45.54 / $75.00 / $248.00	Professional		$45.54	$75.00	$248.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.68 / $99.68 / $99.68	Professional		$99.68	$99.68	$99.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Professional		$50.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $22.45 / $37.42 / $37.42	Facility		$22.45	$37.42	$37.42