Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.00 / $392.71 / $410.01	Facility		$173.00	$392.71	$410.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.00 / $173.00 / $173.00	Professional		$173.00	$173.00	$173.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.40 / $161.19 / $161.19	Facility		$55.40	$161.19	$161.19
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $32.29 / $203.52 / $1,038.08	Professional		$32.29	$203.52	$1,038.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.02 / $263.02 / $263.02	Facility		$263.02	$263.02	$263.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.01 / $192.01 / $263.02	Professional		$192.01	$192.01	$263.02
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 $186.30 / $186.30 / $203.52	Professional		$186.30	$186.30	$203.52