Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.00 / $26.00 / $26.00	Facility		$26.00	$26.00	$26.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.00 / $26.00 / $26.00	Professional		$26.00	$26.00	$26.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $60.84 / $98.39	Professional		$40.00	$60.84	$98.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Professional		$50.00	$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 $6.26 / $6.26 / $6.26	Professional		$6.26	$6.26	$6.26