Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $312.58 / $651.23 / $1,250.33	Facility		$312.58	$651.23	$1,250.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $312.58 / $520.98 / $520.98	Professional		$312.58	$520.98	$520.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $646.01 / $679.35 / $679.35	Professional		$646.01	$679.35	$679.35
Providence Facility/Professional Facility Modifier Low / Median / High Price $525.14 / $525.14 / $525.14	Facility		$525.14	$525.14	$525.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $439.70 / $439.70 / $500.14	Professional		$439.70	$439.70	$500.14
United Facility/Professional Professional Modifier Low / Median / High Price $175.05 / $175.05 / $250.07	Professional		$175.05	$175.05	$250.07