Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Facility		$575.44	$575.44	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $575.44 / $758.58	Professional		$562.34	$575.44	$758.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $85.11 / $93.33	Professional		$60.26	$85.11	$93.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Facility		$1,288.25	$1,288.25	$1,288.25
United Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $602.56	Professional		$426.58	$426.58	$602.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Professional		$812.83	$812.83	$812.83