Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,819.70 / $5,754.40	Facility		$758.58	$1,819.70	$5,754.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $977.24 / $1,412.54	Professional		$758.58	$977.24	$1,412.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $977.24 / $5,623.41	Facility		$812.83	$977.24	$5,623.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,862.09	Professional		$1,548.82	$1,548.82	$1,862.09
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $6,025.60 / $6,025.60 / $6,025.60	Facility		$6,025.60	$6,025.60	$6,025.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,309.57 / $9,549.93 / $9,549.93	Professional		$6,309.57	$9,549.93	$9,549.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,258.93 / $2,344.23	Facility		$912.01	$1,258.93	$2,344.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,023.29 / $1,513.56	Professional		$758.58	$1,023.29	$1,513.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,380.38 / $2,691.53	Professional		$1,258.93	$1,380.38	$2,691.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,258.93 / $3,467.37	Facility		$758.58	$1,258.93	$3,467.37
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $1,318.26 / $2,344.23	Professional		$79.43	$1,318.26	$2,344.23
United Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $524.81 / $1,258.93	Facility		$457.09	$524.81	$1,258.93
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $870.96	Professional		$524.81	$524.81	$870.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $1,258.93 / $1,258.93	Professional		$64.57	$1,258.93	$1,258.93