Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $54.95 / $54.95	Facility		$33.11	$54.95	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $26.92 / $67.61	Professional		$19.95	$26.92	$67.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $39.81 / $75.86	Facility		$25.12	$39.81	$75.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $36.31 / $58.88	Professional		$24.55	$36.31	$58.88
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 $33.88 / $47.86 / $48.98	Facility		$33.88	$47.86	$48.98
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $75.86	Professional		$72.44	$72.44	$75.86