Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $547.20 / $1,343.52 / $3,726.43	Facility		$547.20	$1,343.52	$3,726.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $392.40 / $540.00 / $828.00	Professional		$392.40	$540.00	$828.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $720.00 / $2,066.40 / $3,772.80	Facility		$720.00	$2,066.40	$3,772.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $720.00 / $720.00 / $720.00	Professional		$720.00	$720.00	$720.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $473.85 / $1,638.00 / $3,208.43	Facility		$473.85	$1,638.00	$3,208.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $876.87 / $876.87 / $1,050.58	Professional		$876.87	$876.87	$1,050.58
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,152.00 / $3,420.00 / $3,420.00	Facility		$1,152.00	$3,420.00	$3,420.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,585.60 / $3,585.60 / $5,400.00	Professional		$3,585.60	$3,585.60	$5,400.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $432.00 / $720.00 / $1,062.83	Facility		$432.00	$720.00	$1,062.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $720.00 / $720.00 / $900.00	Professional		$720.00	$720.00	$900.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $648.00 / $900.00 / $1,620.00	Professional		$648.00	$900.00	$1,620.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $468.00 / $720.72 / $2,175.21	Facility		$468.00	$720.72	$2,175.21
Providence Facility/Professional Professional Modifier Low / Median / High Price $648.00 / $864.00 / $1,260.00	Professional		$648.00	$864.00	$1,260.00
United Facility/Professional Professional Modifier Low / Median / High Price $302.39 / $302.39 / $460.80	Professional		$302.39	$302.39	$460.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $228.90 / $280.80 / $720.00	Professional		$228.90	$280.80	$720.00