Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $316.23 / $416.87	Professional		$169.82	$316.23	$416.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $109.65 / $181.97	Facility		$75.86	$109.65	$181.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $104.71 / $169.82	Professional		$75.86	$104.71	$169.82
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 $128.82 / $165.96 / $186.21	Facility		$128.82	$165.96	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $100.00 / $134.90	Professional		$64.57	$100.00	$134.90