Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Facility		$83.18	$83.18	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $67.61 / $83.18	Professional		$57.54	$67.61	$83.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $141.25 / $181.97	Facility		$72.44	$141.25	$181.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $144.54 / $186.21	Professional		$74.13	$144.54	$186.21
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 $125.89 / $147.91 / $154.88	Facility		$125.89	$147.91	$154.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Professional		$114.82	$114.82	$114.82