Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $165.00 / $190.00	Facility		$150.00	$165.00	$190.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $253.46 / $253.46 / $420.60	Facility		$253.46	$253.46	$420.60