Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $120.23 / $501.19	Facility		$109.65	$120.23	$501.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $338.84	Facility		$199.53	$199.53	$338.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $165.96 / $204.17	Facility		$125.89	$165.96	$204.17
Providence Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $501.19	Facility		$120.23	$120.23	$501.19