Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $400.00 / $600.00	Facility		$30.00	$400.00	$600.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $162.47 / $303.10 / $626.64	Facility		$162.47	$303.10	$626.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $344.00 / $649.12 / $1,008.00	Professional		$344.00	$649.12	$1,008.00
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $196.62 / $196.62 / $263.20	Professional	QK	$196.62	$196.62	$263.20
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $196.62 / $196.62 / $263.20	Professional	QX	$196.62	$196.62	$263.20
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $196.62 / $196.62 / $263.20	Professional	QY	$196.62	$196.62	$263.20
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $4,334.00 / $4,889.07 / $12,172.93	Facility		$4,334.00	$4,889.07	$12,172.93