Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,625.00 / $5,250.00 / $10,500.00	Facility		$2,625.00	$5,250.00	$10,500.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,625.00 / $4,200.00 / $4,200.00	Professional		$2,625.00	$4,200.00	$4,200.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,275.00 / $2,275.00 / $2,275.00	Facility		$2,275.00	$2,275.00	$2,275.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $5,425.00 / $5,705.00 / $5,705.00	Professional		$5,425.00	$5,705.00	$5,705.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,275.00 / $2,275.00 / $2,275.00	Facility		$2,275.00	$2,275.00	$2,275.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $3,692.50 / $3,692.50 / $4,200.00	Professional		$3,692.50	$3,692.50	$4,200.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,470.00 / $1,470.00 / $2,100.00	Professional		$1,470.00	$1,470.00	$2,100.00