Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $14,454.40 / $25,703.96	Facility		$3,311.31	$14,454.40	$25,703.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $562.34 / $562.34	Professional		$562.34	$562.34	$562.34
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 $107.15 / $331.13 / $3,630.78	Facility		$107.15	$331.13	$3,630.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $141.25	Facility		$128.82	$128.82	$141.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $194.98 / $758.58	Professional		$128.82	$194.98	$758.58
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $165.96 / $275.42	Professional		$134.90	$165.96	$275.42