Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $90.80 / $94.80	Facility		$40.00	$90.80	$94.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $40.00	Professional		$40.00	$40.00	$40.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $15.55 / $90.00 / $100.00	Facility		$15.55	$90.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $45.36 / $126.41 / $575.00	Professional		$45.36	$126.41	$575.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$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
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $126.41 / $259.32 / $259.32	Professional		$126.41	$259.32	$259.32