Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.42 / $122.42 / $122.42	Facility		$122.42	$122.42	$122.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.11 / $122.42 / $122.42	Professional		$99.11	$122.42	$122.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.90 / $84.90 / $84.90	Professional		$84.90	$84.90	$84.90
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 $81.30 / $230.52 / $230.52	Professional		$81.30	$230.52	$230.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.85 / $9.85 / $9.85	Professional		$9.85	$9.85	$9.85
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 $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20