Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $3,467.37 / $16,218.10	Facility		$199.53	$3,467.37	$16,218.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $870.96	Facility		$758.58	$758.58	$870.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $154.88 / $263.03	Facility		$107.15	$154.88	$263.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $208.93 / $218.78	Facility		$181.97	$208.93	$218.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $151.36	Facility		$147.91	$147.91	$151.36
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $645.65 / $5,754.40	Facility		$158.49	$645.65	$5,754.40