Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.57 / $271.33 / $271.33	Professional		$254.57	$271.33	$271.33
BCBS Facility/Professional Facility Modifier Low / Median / High Price $467.99 / $2,359.98 / $3,591.12	Facility		$467.99	$2,359.98	$3,591.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.99 / $467.99 / $467.99	Professional		$467.99	$467.99	$467.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $467.99 / $467.99	Professional		$100.00	$467.99	$467.99
Providence Facility/Professional Facility Modifier Low / Median / High Price $752.40 / $752.40 / $752.40	Facility		$752.40	$752.40	$752.40
United Facility/Professional Professional Modifier Low / Median / High Price $249.02 / $283.94 / $614.44	Professional		$249.02	$283.94	$614.44