Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $238.26 / $238.26 / $400.00	Facility		$238.26	$238.26	$400.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $375.00 / $375.00 / $375.00	Facility		$375.00	$375.00	$375.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $375.00 / $375.00 / $375.00	Facility		$375.00	$375.00	$375.00