Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $30.90 / $30.90	Facility		$30.90	$30.90	$30.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $30.90 / $33.11	Professional		$18.20	$30.90	$33.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $257.04 / $426.58	Facility		$120.23	$257.04	$426.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $26.30 / $34.67	Professional		$19.50	$26.30	$34.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $48.98	Professional		$47.86	$47.86	$48.98
Providence Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $22.39 / $31.62	Facility		$22.39	$22.39	$31.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.62 / $18.62	Professional		$18.20	$18.62	$18.62
United Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $36.31 / $42.66	Facility		$32.36	$36.31	$42.66
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $47.86 / $69.18	Professional		$28.84	$47.86	$69.18