Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $5,495.41 / $20,892.96	Facility		$2,818.38	$5,495.41	$20,892.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $4,466.84 / $5,623.41	Facility		$2,630.27	$4,466.84	$5,623.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $4,168.69 / $4,365.16	Facility		$3,162.28	$4,168.69	$4,365.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $2,951.21 / $2,951.21	Facility		$2,951.21	$2,951.21	$2,951.21
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,454.71 / $37,153.52	Facility		$707.95	$2,454.71	$37,153.52