Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $269.15 / $309.03	Professional		$251.19	$269.15	$309.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $257.04 / $288.40	Professional		$229.09	$257.04	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $22.91	Professional		$22.91	$22.91	$22.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $33.11 / $75.86	Professional		$30.20	$33.11	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $288.40 / $302.00	Facility		$288.40	$288.40	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $331.13	Professional		$257.04	$257.04	$331.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $323.59 / $575.44	Professional		$302.00	$323.59	$575.44