Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,663.50 / $1,663.50 / $1,663.50	Professional		$1,663.50	$1,663.50	$1,663.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $293.56 / $391.41 / $391.41	Professional		$293.56	$391.41	$391.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $414.89 / $3,522.69 / $5,629.71	Professional		$414.89	$3,522.69	$5,629.71
Providence Facility/Professional Facility Modifier Low / Median / High Price $266.16 / $1,663.50 / $1,663.50	Facility		$266.16	$1,663.50	$1,663.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,663.50 / $1,663.50 / $1,663.50	Professional		$1,663.50	$1,663.50	$1,663.50
United Facility/Professional Professional Modifier Low / Median / High Price $1,330.80 / $1,330.80 / $4,425.89	Professional		$1,330.80	$1,330.80	$4,425.89