Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,946.00 / $2,736.00 / $3,003.00	Facility		$1,946.00	$2,736.00	$3,003.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $50.00	Professional		$40.00	$40.00	$50.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,170.00 / $5,575.00 / $13,486.00	Facility		$1,170.00	$5,575.00	$13,486.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $84.19 / $84.19 / $84.19	Professional		$84.19	$84.19	$84.19