Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Facility		$245.47	$245.47	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $302.00	Professional		$245.47	$245.47	$302.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $1,230.27 / $1,905.46	Facility		$446.68	$1,230.27	$1,905.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $100.00	Professional		$32.36	$50.12	$100.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $794.33 / $794.33	Facility		$309.03	$794.33	$794.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $954.99 / $1,778.28	Facility		$724.44	$954.99	$1,778.28
United Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,148.15 / $2,089.30	Facility		$870.96	$1,148.15	$2,089.30
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $199.53 / $707.95	Professional		$131.83	$199.53	$707.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26