Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $389.05 / $20,892.96	Facility		$204.17	$389.05	$20,892.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $316.23 / $389.05	Facility		$190.55	$316.23	$389.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $288.40 / $309.03	Facility		$251.19	$288.40	$309.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
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