Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,950.00 / $3,950.00 / $3,950.00	Facility		$3,950.00	$3,950.00	$3,950.00
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 $158.00 / $1,500.00 / $6,300.00	Facility		$158.00	$1,500.00	$6,300.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $478.00 / $1,137.00 / $6,004.00	Facility		$478.00	$1,137.00	$6,004.00