Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $257.04	Professional		$245.47	$245.47	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $169.82	Professional		$144.54	$144.54	$169.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $93.33	Professional		$72.44	$72.44	$93.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Professional		$309.03	$309.03	$309.03