Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,071.52 / $20,892.96	Facility		$758.58	$1,071.52	$20,892.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $891.25 / $1,071.52	Facility		$524.81	$891.25	$1,071.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $794.33 / $831.76	Facility		$691.83	$794.33	$831.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $562.34 / $575.44	Facility		$562.34	$562.34	$575.44
United Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $3,311.31 / $37,153.52	Facility		$1,122.02	$3,311.31	$37,153.52