Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $323.59	Facility		$323.59	$323.59	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $257.04 / $346.74	Professional		$208.93	$257.04	$346.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $602.56 / $13,803.84	Facility		$323.59	$602.56	$13,803.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $562.34 / $691.83	Professional		$323.59	$562.34	$691.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $64.57	Professional		$44.67	$50.12	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $537.03 / $562.34	Facility		$457.09	$537.03	$562.34
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $537.03 / $537.03	Professional		$537.03	$537.03	$537.03