Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $4,466.84 / $18,620.87	Facility		$218.78	$4,466.84	$18,620.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $257.04 / $338.84	Facility		$158.49	$257.04	$338.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $223.87 / $245.47	Facility		$199.53	$223.87	$245.47
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $165.96	Facility		$162.18	$162.18	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $1,071.52 / $6,165.95	Facility		$501.19	$1,071.52	$6,165.95