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
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $234.42 / $234.42	Facility		$154.88	$234.42	$234.42