Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,995.26 / $3,548.13	Facility		$1,348.96	$1,995.26	$3,548.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,230.27	Professional		$1,230.27	$1,230.27	$1,230.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Facility		$446.68	$446.68	$446.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $724.44 / $1,513.56	Facility		$407.38	$724.44	$1,513.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $407.38 / $537.03	Professional		$407.38	$407.38	$537.03
United Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Professional		$446.68	$446.68	$446.68