Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $5,623.41 / $7,244.36	Professional		$2,691.53	$5,623.41	$7,244.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $2,754.23 / $3,890.45	Facility		$1,548.82	$2,754.23	$3,890.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $2,454.71 / $3,801.89	Professional		$1,412.54	$2,454.71	$3,801.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $70.79 / $79.43	Professional		$60.26	$70.79	$79.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,951.21 / $3,090.30	Facility		$2,137.96	$2,951.21	$3,090.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,089.30 / $2,089.30	Facility		$2,089.30	$2,089.30	$2,089.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,630.27 / $3,981.07	Professional		$2,089.30	$2,630.27	$3,981.07
United Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,905.46 / $2,754.23	Professional		$1,288.25	$1,905.46	$2,754.23