Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $61.66 / $74.13	Professional		$57.54	$61.66	$74.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $0.79 / $0.79 / $1.20	Facility		$0.79	$0.79	$1.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $0.79 / $0.79 / $1.20	Professional		$0.79	$0.79	$1.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $56.23 / $56.23	Facility		$45.71	$56.23	$56.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $38.02	Facility		$38.02	$38.02	$38.02
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $54.95 / $79.43	Professional		$38.02	$54.95	$79.43
United Facility/Professional Facility Modifier Low / Median / High Price $0.30 / $23.99 / $38.90	Facility		$0.30	$23.99	$38.90