Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $338.84	Facility		$199.53	$199.53	$338.84
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $28.84 / $28.84	Facility		$28.84	$28.84	$28.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $109.65 / $120.23	Facility		$75.86	$109.65	$120.23