Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $5,370.32 / $6,606.93	Facility		$2,884.03	$5,370.32	$6,606.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $5,128.61 / $6,456.54	Facility		$2,818.38	$5,128.61	$6,456.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,466.84 / $5,128.61 / $5,495.41	Facility		$4,466.84	$5,128.61	$5,495.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $3,548.13 / $3,715.35	Facility		$3,548.13	$3,548.13	$3,715.35
United Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $2,691.53 / $3,715.35	Facility		$1,318.26	$2,691.53	$3,715.35