Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $67.15 / $67.15	Professional		$58.88	$67.15	$67.15
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $23.63 / $186.11 / $200.43	Facility		$23.63	$186.11	$200.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $460.82 / $552.98 / $614.41	Professional		$460.82	$552.98	$614.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.72 / $30.72 / $30.72	Facility		$30.72	$30.72	$30.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.11 / $30.72 / $869.25	Professional		$26.11	$30.72	$869.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $45.00 / $50.00	Professional		$40.00	$45.00	$50.00
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