Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $5,888.44 / $27,542.29 / $48,977.88	Facility		$5,888.44	$27,542.29	$48,977.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Professional		$1,659.59	$1,659.59	$1,659.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $64.57	Professional		$32.36	$50.12	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,288.25 / $4,897.79	Facility		$724.44	$1,288.25	$4,897.79
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $870.96 / $912.01	Facility		$870.96	$870.96	$912.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,348.96 / $1,659.59	Professional		$870.96	$1,348.96	$1,659.59
United Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,047.13 / $1,778.28	Professional		$794.33	$1,047.13	$1,778.28