Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $2,454.71 / $20,892.96	Facility		$1,621.81	$2,454.71	$20,892.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,778.28 / $2,187.76	Facility		$1,047.13	$1,778.28	$2,187.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,659.59 / $1,737.80	Facility		$1,412.54	$1,659.59	$1,737.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,174.90	Facility		$1,174.90	$1,174.90	$1,174.90
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,454.71 / $37,153.52	Facility		$707.95	$2,454.71	$37,153.52