Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.07 / $18.07 / $18.07	Facility		$18.07	$18.07	$18.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.07 / $18.07 / $18.07	Professional		$18.07	$18.07	$18.07
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $100.00 / $100.00	Facility		$65.00	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $12.64 / $75.00 / $100.00	Professional		$12.64	$75.00	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $75.00	Professional		$30.00	$30.00	$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
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $20.00 / $20.00	Professional		$20.00	$20.00	$20.00