Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,365.16 / $20,892.96	Facility		$2,818.38	$4,365.16	$20,892.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $3,630.78 / $4,570.88	Facility		$2,137.96	$3,630.78	$4,570.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $3,235.94 / $3,467.37	Facility		$2,570.40	$3,235.94	$3,467.37
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $2,344.23	Facility		$2,290.87	$2,290.87	$2,344.23
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