Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $223.87 / $398.11	Facility		$199.53	$223.87	$398.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $75.86	Professional		$39.81	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $239.88 / $239.88	Facility		$131.83	$239.88	$239.88