Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $38.90	Professional		$30.90	$30.90	$38.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $14.79 / $23.99 / $269.15	Facility		$14.79	$23.99	$269.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $21.88 / $37.15	Professional		$14.13	$21.88	$37.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $70.79	Professional		$70.79	$70.79	$70.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $32.36 / $36.31	Facility		$26.92	$32.36	$36.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $22.39 / $22.39	Facility		$22.39	$22.39	$22.39
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $27.54 / $41.69	Professional		$22.39	$27.54	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $26.92 / $45.71	Professional		$17.78	$26.92	$45.71