Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $225.83 / $225.83 / $225.83	Facility		$225.83	$225.83	$225.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.80 / $225.83 / $744.11	Professional		$216.80	$225.83	$744.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $257.89 / $257.89 / $257.89	Professional		$257.89	$257.89	$257.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $4.53 / $159.97 / $239.38	Facility		$4.53	$159.97	$239.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $102.44 / $102.44 / $102.44	Professional		$102.44	$102.44	$102.44
United Facility/Professional Professional Modifier Low / Median / High Price $213.22 / $287.82 / $341.90	Professional		$213.22	$287.82	$341.90