Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $263.03 / $316.23	Professional		$251.19	$263.03	$316.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Facility		$302.00	$302.00	$302.00
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 $346.74 / $371.54 / $588.84	Facility		$346.74	$371.54	$588.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $398.11 / $741.31	Facility		$199.53	$398.11	$741.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Professional		$346.74	$346.74	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $234.42 / $316.23	Professional		$223.87	$234.42	$316.23