Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,700.00 / $5,400.00 / $10,800.00	Facility		$2,700.00	$5,400.00	$10,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,700.00 / $4,320.00 / $4,320.00	Professional		$2,700.00	$4,320.00	$4,320.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $5,580.00 / $5,868.00 / $5,868.00	Professional		$5,580.00	$5,868.00	$5,868.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $3,600.00 / $3,600.00 / $3,600.00	Facility		$3,600.00	$3,600.00	$3,600.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $3,798.00 / $4,320.00 / $5,004.00	Professional		$3,798.00	$4,320.00	$5,004.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,512.00 / $1,512.00 / $2,160.00	Professional		$1,512.00	$1,512.00	$2,160.00