Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,756.25 / $5,512.50 / $11,025.00	Facility		$2,756.25	$5,512.50	$11,025.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,756.25 / $2,756.25 / $2,756.25	Professional		$2,756.25	$2,756.25	$2,756.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $5,696.25 / $5,990.25 / $5,990.25	Professional		$5,696.25	$5,990.25	$5,990.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $3,675.00 / $3,675.00 / $4,630.50	Facility		$3,675.00	$3,675.00	$4,630.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $3,877.13 / $4,410.00 / $5,108.25	Professional		$3,877.13	$4,410.00	$5,108.25
United Facility/Professional Facility Modifier Low / Median / High Price $2,205.00 / $3,307.50 / $5,512.50	Facility		$2,205.00	$3,307.50	$5,512.50
United Facility/Professional Professional Modifier Low / Median / High Price $1,543.50 / $1,543.50 / $2,205.00	Professional		$1,543.50	$1,543.50	$2,205.00