Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,737.80 / $20,892.96	Facility		$724.44	$1,737.80	$20,892.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $851.14 / $1,047.13	Facility		$467.74	$851.14	$1,047.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $741.31 / $794.33	Facility		$588.84	$741.31	$794.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $537.03	Facility		$524.81	$524.81	$537.03
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