Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $660.69 / $1,584.89	Facility		$331.13	$660.69	$1,584.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $281.84 / $416.87	Professional		$208.93	$281.84	$416.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $346.74 / $1,621.81	Facility		$316.23	$346.74	$1,621.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $346.74 / $588.84	Professional		$281.84	$346.74	$588.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $380.19 / $616.60	Facility		$316.23	$380.19	$616.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $616.60 / $1,047.13	Facility		$346.74	$616.60	$1,047.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $416.87	Professional		$316.23	$316.23	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $389.05	Professional		$147.91	$147.91	$389.05