Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5.01 / $5.01 / $11.75	Facility		$5.01	$5.01	$11.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $5.01 / $5.01	Professional		$5.01	$5.01	$5.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $30.90	Professional		$30.90	$30.90	$30.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $85.11	Professional		$32.36	$33.11	$85.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Facility		$616.60	$616.60	$616.60
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Professional		$616.60	$616.60	$616.60