Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $6,309.57 / $18,620.87	Facility		$741.31	$6,309.57	$18,620.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $870.96 / $1,071.52	Facility		$489.78	$870.96	$1,071.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $776.25 / $812.83	Facility		$660.69	$776.25	$812.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $537.03 / $549.54	Facility		$537.03	$537.03	$549.54
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