Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $935.00 / $3,682.00 / $12,040.00	Facility		$935.00	$3,682.00	$12,040.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $577.60 / $899.37 / $993.07	Professional		$577.60	$899.37	$993.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,633.92 / $3,752.69 / $4,237.30	Facility		$3,633.92	$3,752.69	$4,237.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $657.38 / $821.72 / $1,180.68	Professional		$657.38	$821.72	$1,180.68
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,716.26 / $16,743.30 / $16,743.30	Facility		$5,716.26	$16,743.30	$16,743.30
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $7,091.12 / $7,329.36 / $8,781.98	Professional		$7,091.12	$7,329.36	$8,781.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $899.37 / $1,052.38 / $1,996.12	Facility		$899.37	$1,052.38	$1,996.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $971.11 / $5,478.00 / $9,074.00	Professional		$971.11	$5,478.00	$9,074.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $899.37 / $1,073.08 / $2,655.61	Facility		$899.37	$1,073.08	$2,655.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $971.11 / $1,180.68 / $1,443.29	Professional		$971.11	$1,180.68	$1,443.29
United Facility/Professional Facility Modifier Low / Median / High Price $2,182.00 / $6,566.00 / $13,134.00	Facility		$2,182.00	$6,566.00	$13,134.00
United Facility/Professional Professional Modifier Low / Median / High Price $789.82 / $1,060.83 / $1,722.86	Professional		$789.82	$1,060.83	$1,722.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $813.52 / $888.60 / $1,214.82	Professional		$813.52	$888.60	$1,214.82