Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $794.33 / $1,348.96	Facility		$141.25	$794.33	$1,348.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $102.33	Professional		$89.13	$89.13	$102.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $63.10 / $114.82	Facility		$25.12	$63.10	$114.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $50.12 / $64.57	Professional		$33.11	$50.12	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $72.44 / $72.44	Facility		$28.18	$72.44	$72.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $85.11 / $162.18	Facility		$61.66	$85.11	$162.18
United Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $109.65 / $194.98	Facility		$81.28	$109.65	$194.98