Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Professional		$295.12	$295.12	$295.12
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $794.33 / $2,570.40	Facility		$478.63	$794.33	$2,570.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $794.33 / $1,023.29	Professional		$478.63	$794.33	$1,023.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $64.57	Professional		$44.67	$50.12	$64.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $691.83 / $707.95	Facility		$575.44	$691.83	$707.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Facility		$489.78	$489.78	$489.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $794.33 / $1,023.29	Professional		$489.78	$794.33	$1,023.29
United Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $489.78 / $891.25	Professional		$389.05	$489.78	$891.25