Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $7,762.47 / $7,762.47	Facility		$1,000.00	$7,762.47	$7,762.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $97.72 / $120.23	Professional		$67.61	$97.72	$120.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $60.26 / $173.78	Professional		$50.12	$60.26	$173.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $107.15 / $162.18	Facility		$67.61	$107.15	$162.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $138.04 / $204.17	Professional		$117.49	$138.04	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $1,096.48 / $1,412.54	Facility		$229.09	$1,096.48	$1,412.54
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $141.25 / $194.98	Professional		$104.71	$141.25	$194.98