Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $72.44 / $147.91	Professional		$58.88	$72.44	$147.91
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $44.67 / $85.11	Facility		$33.11	$44.67	$85.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $46.77 / $89.13	Professional		$33.11	$46.77	$89.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $44.67 / $50.12	Professional		$33.11	$44.67	$50.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $74.13 / $74.13	Facility		$61.66	$74.13	$74.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $87.10 / $109.65	Professional		$51.29	$87.10	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $51.29 / $95.50	Professional		$35.48	$51.29	$95.50