Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $93.33 / $120.23	Facility		$56.23	$93.33	$120.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $54.95 / $104.71	Facility		$35.48	$54.95	$104.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $85.11 / $89.13	Facility		$72.44	$85.11	$89.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $61.66	Facility		$60.26	$60.26	$61.66