Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $363.08 / $630.96	Facility		$181.97	$363.08	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $54.95 / $263.03	Professional		$28.84	$54.95	$263.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $398.11 / $676.08	Facility		$141.25	$398.11	$676.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $60.26	Professional		$32.36	$50.12	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $380.19 / $380.19	Facility		$147.91	$380.19	$380.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $446.68 / $851.14	Facility		$302.00	$446.68	$851.14
United Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $489.78 / $870.96	Facility		$363.08	$489.78	$870.96