Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $6,456.54 / $20,892.96	Facility		$3,162.28	$6,456.54	$20,892.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $5,370.32 / $6,606.93	Facility		$3,162.28	$5,370.32	$6,606.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $4,897.79 / $5,248.07	Facility		$4,265.80	$4,897.79	$5,248.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $3,467.37 / $3,630.78	Facility		$3,467.37	$3,467.37	$3,630.78
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