Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $1,905.46	Facility		$812.83	$812.83	$1,905.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $758.58 / $933.25	Professional		$588.84	$758.58	$933.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $1,737.80	Facility		$912.01	$912.01	$1,737.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Professional		$912.01	$912.01	$912.01
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $2,398.83 / $4,466.84	Facility		$309.03	$2,398.83	$4,466.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $2,238.72 / $3,162.28	Professional		$245.47	$2,238.72	$3,162.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $1,659.59 / $2,818.38	Professional		$75.86	$1,659.59	$2,818.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,949.84 / $2,041.74	Facility		$1,412.54	$1,949.84	$2,041.74
United Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $954.99 / $954.99	Facility		$954.99	$954.99	$954.99
United Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Professional		$891.25	$891.25	$891.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,737.80 / $2,754.23	Professional		$1,318.26	$1,737.80	$2,754.23