Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $154.88	Professional		$125.89	$125.89	$154.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $616.60 / $1,000.00	Facility		$281.84	$616.60	$1,000.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $107.15 / $125.89	Professional		$93.33	$107.15	$125.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Professional		$114.82	$114.82	$114.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $100.00 / $114.82	Facility		$57.54	$100.00	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $177.83	Professional		$147.91	$147.91	$177.83