Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $271.02 / $542.04 / $1,084.10	Facility		$271.02	$542.04	$1,084.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $271.02 / $433.64 / $433.64	Professional		$271.02	$433.64	$433.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $560.12 / $589.03 / $589.03	Professional		$560.12	$589.03	$589.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $455.33 / $455.33 / $455.33	Facility		$455.33	$455.33	$455.33
Providence Facility/Professional Professional Modifier Low / Median / High Price $381.25 / $381.25 / $433.64	Professional		$381.25	$381.25	$433.64
United Facility/Professional Professional Modifier Low / Median / High Price $151.78 / $151.78 / $216.82	Professional		$151.78	$151.78	$216.82