Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $147.91 / $239.88	Professional		$83.18	$147.91	$239.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $11.22 / $17.38 / $83.18	Facility		$11.22	$17.38	$83.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $17.38 / $75.86	Professional		$11.22	$17.38	$75.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $70.79 / $85.11	Professional		$60.26	$70.79	$85.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $93.33 / $112.20	Facility		$22.39	$93.33	$112.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $72.44 / $131.83	Professional		$44.67	$72.44	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $39.81 / $64.57	Professional		$13.49	$39.81	$64.57