Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $10,232.93 / $28,183.83	Facility		$870.96	$10,232.93	$28,183.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $602.56 / $954.99	Professional		$173.78	$602.56	$954.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Professional		$1,819.70	$1,819.70	$1,819.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $64.57	Professional		$32.36	$50.12	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $794.33 / $1,071.52	Facility		$537.03	$794.33	$1,071.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $851.14	Facility		$851.14	$851.14	$851.14
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,445.44 / $1,819.70	Professional		$851.14	$1,445.44	$1,819.70
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,202.26 / $1,778.28	Professional		$870.96	$1,202.26	$1,778.28
United Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $3,311.31 / $37,153.52	Facility		$1,122.02	$3,311.31	$37,153.52
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $1,071.52 / $1,584.89	Professional		$524.81	$1,071.52	$1,584.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Professional		$257.04	$257.04	$257.04