Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $1,737.80 / $20,892.96	Facility		$416.87	$1,737.80	$20,892.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $478.63 / $630.96	Facility		$288.40	$478.63	$630.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $426.58 / $467.74	Facility		$371.54	$426.58	$467.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
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