Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $2,818.38 / $18,620.87	Facility		$416.87	$2,818.38	$18,620.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $467.74 / $575.44	Facility		$281.84	$467.74	$575.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $436.52 / $467.74	Facility		$380.19	$436.52	$467.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $316.23	Facility		$309.03	$309.03	$316.23
United Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $660.69 / $6,165.95	Facility		$190.55	$660.69	$6,165.95