Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Facility		$147.91	$147.91	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $131.83 / $173.78	Professional		$97.72	$131.83	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Facility		$302.00	$302.00	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $302.00	Professional		$147.91	$147.91	$302.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $407.38 / $588.84	Facility		$66.07	$407.38	$588.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $407.38 / $512.86	Professional		$354.81	$407.38	$512.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $44.67 / $60.26	Professional		$30.20	$44.67	$60.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $363.08 / $363.08	Facility		$295.12	$363.08	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $257.04	Professional		$134.90	$154.88	$257.04