Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $724.44	Facility		$309.03	$309.03	$724.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $295.12 / $309.03	Professional		$288.40	$295.12	$309.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $446.68	Facility		$309.03	$309.03	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Professional		$309.03	$309.03	$309.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $602.56 / $724.44	Facility		$295.12	$602.56	$724.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $602.56 / $812.83	Professional		$295.12	$602.56	$812.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $75.86	Professional		$44.67	$50.12	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $537.03 / $537.03	Facility		$446.68	$537.03	$537.03
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $363.08	Professional		$302.00	$302.00	$363.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $446.68 / $478.63	Professional		$338.84	$446.68	$478.63