Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.25 / $160.50 / $321.00	Facility		$80.25	$160.50	$321.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.25 / $128.40 / $128.40	Professional		$80.25	$128.40	$128.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $165.85 / $174.41 / $174.41	Professional		$165.85	$174.41	$174.41
Providence Facility/Professional Facility Modifier Low / Median / High Price $107.00 / $107.00 / $134.82	Facility		$107.00	$107.00	$134.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $112.89 / $128.40 / $148.72	Professional		$112.89	$128.40	$148.72
United Facility/Professional Professional Modifier Low / Median / High Price $44.94 / $44.94 / $64.20	Professional		$44.94	$44.94	$64.20