Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $575.44 / $1,737.80	Facility		$323.59	$575.44	$1,737.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $562.34 / $676.08	Professional		$309.03	$562.34	$676.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $147.91 / $169.82	Facility		$79.43	$147.91	$169.82