Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $346.74	Professional		$229.09	$229.09	$346.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Facility		$229.09	$229.09	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $165.96	Professional		$100.00	$100.00	$165.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $72.44 / $85.11	Professional		$44.67	$72.44	$85.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,981.07 / $3,981.07 / $3,981.07	Facility		$3,981.07	$3,981.07	$3,981.07
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,981.07 / $3,981.07 / $3,981.07	Professional		$3,981.07	$3,981.07	$3,981.07