Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $588.84 / $588.84	Facility		$588.84	$588.84	$588.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $588.84 / $602.56	Professional		$588.84	$588.84	$602.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $1,659.59 / $2,884.03	Facility		$616.60	$1,659.59	$2,884.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $7.59 / $7.59 / $7.59	Professional		$7.59	$7.59	$7.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $75.86 / $100.00	Professional		$50.12	$75.86	$100.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $1,412.54 / $1,412.54	Facility		$562.34	$1,412.54	$1,412.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,698.24 / $3,162.28	Facility		$1,288.25	$1,698.24	$3,162.28
United Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $3,548.13 / $6,309.57	Facility		$2,630.27	$3,548.13	$6,309.57
United Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $478.63 / $676.08	Professional		$9.77	$478.63	$676.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $1,000.00	Professional		$251.19	$251.19	$1,000.00