Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
HealthNet Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $3,162.28	Facility		$3,162.28	$3,162.28	$3,162.28
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 $85.11 / $85.11 / $85.11	Facility		$85.11	$85.11	$85.11