Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.28 / $575.28 / $575.28	Facility		$575.28	$575.28	$575.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $566.24 / $575.28 / $575.28	Professional		$566.24	$575.28	$575.28
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $759.90 / $759.90	Facility		$100.00	$759.90	$759.90
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $810.05 / $960.00 / $1,280.00	Professional		$810.05	$960.00	$1,280.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $76.50 / $93.50	Professional		$60.00	$76.50	$93.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,295.00 / $1,295.00 / $1,295.00	Facility		$1,295.00	$1,295.00	$1,295.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $810.05 / $810.05 / $810.05	Professional		$810.05	$810.05	$810.05