Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,041.09 / $1,041.09 / $1,041.09	Facility		$1,041.09	$1,041.09	$1,041.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $806.25 / $806.25 / $806.25	Facility		$806.25	$806.25	$806.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $806.25 / $806.25 / $806.25	Facility		$806.25	$806.25	$806.25