Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $3,467.37 / $10,232.93	Facility		$891.25	$3,467.37	$10,232.93
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 $741.31 / $1,047.13 / $1,778.28	Facility		$741.31	$1,047.13	$1,778.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,348.96 / $1,445.44	Facility		$1,202.26	$1,348.96	$1,445.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $977.24 / $1,000.00	Facility		$977.24	$977.24	$1,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $5,495.41 / $19,054.61	Facility		$3,019.95	$5,495.41	$19,054.61