Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Facility		$61.66	$61.66	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $52.48 / $64.57	Professional		$25.12	$52.48	$64.57
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $48.98 / $158.49	Facility		$30.20	$48.98	$158.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $42.66 / $158.49	Professional		$25.70	$42.66	$158.49
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 $100.00 / $138.04 / $141.25	Facility		$100.00	$138.04	$141.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95