Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $165.08 / $165.08	Facility		$80.00	$165.08	$165.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $50.00	Professional		$45.00	$50.00	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $107.56 / $126.54 / $79,999.20	Facility		$107.56	$126.54	$79,999.20