Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $977.24 / $3,162.28	Facility		$660.69	$977.24	$3,162.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $562.34 / $831.76	Professional		$416.87	$562.34	$831.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $707.95 / $3,235.94	Facility		$630.96	$707.95	$3,235.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $707.95 / $1,202.26	Professional		$562.34	$707.95	$1,202.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $75.86	Professional		$44.67	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $776.25 / $1,230.27	Facility		$630.96	$776.25	$1,230.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,230.27 / $2,089.30	Facility		$707.95	$1,230.27	$2,089.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $630.96 / $831.76	Professional		$630.96	$630.96	$831.76
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $776.25	Professional		$295.12	$295.12	$776.25