Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $83.18	Professional		$47.86	$47.86	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $588.84 / $758.58	Professional		$436.52	$588.84	$758.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Professional		$446.68	$446.68	$446.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $3,801.89 / $3,801.89	Facility		$3,801.89	$3,801.89	$3,801.89
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $269.15 / $316.23	Professional		$190.55	$269.15	$316.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Professional		$69.18	$69.18	$69.18