Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $1,737.80 / $20,892.96	Facility		$331.13	$1,737.80	$20,892.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $416.87 / $691.83	Facility		$309.03	$416.87	$691.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $363.08 / $501.19	Facility		$302.00	$363.08	$501.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $251.19	Facility		$245.47	$245.47	$251.19
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