Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $7,244.36 / $21,877.62	Facility		$229.09	$7,244.36	$21,877.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $269.15 / $478.63	Facility		$158.49	$269.15	$478.63
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $251.19 / $537.03	Facility		$208.93	$251.19	$537.03
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $173.78	Facility		$169.82	$169.82	$173.78
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