Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,700.00 / $5,625.00 / $10,800.00	Facility		$2,700.00	$5,625.00	$10,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,700.00 / $4,500.00 / $4,500.00	Professional		$2,700.00	$4,500.00	$4,500.00
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 $4,536.00 / $4,536.00 / $4,536.00	Facility		$4,536.00	$4,536.00	$4,536.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $3,798.00 / $3,798.00 / $4,320.00	Professional		$3,798.00	$3,798.00	$4,320.00
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