Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $200.00 / $322.00	Facility		$200.00	$200.00	$322.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,278.75 / $4,278.75 / $4,278.75	Facility		$4,278.75	$4,278.75	$4,278.75
Providence Facility/Professional Facility Modifier Low / Median / High Price $11.19 / $52.70 / $373.08	Facility		$11.19	$52.70	$373.08