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
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $58.00 / $58.00 / $79.00	Facility		$58.00	$58.00	$79.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $95.04 / $120.00	Facility		$50.00	$95.04	$120.00