Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $1,737.80 / $20,892.96	Facility		$151.36	$1,737.80	$20,892.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Facility		$1,122.02	$1,122.02	$1,122.02
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $162.18 / $204.17	Facility		$104.71	$162.18	$204.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $158.49 / $165.96	Facility		$123.03	$158.49	$165.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $112.20	Facility		$104.71	$104.71	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $794.33 / $3,630.78	Facility		$707.95	$794.33	$3,630.78