Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.48 / $235.00 / $653.44	Facility		$80.48	$235.00	$653.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.11 / $88.53 / $108.65	Professional		$75.11	$88.53	$108.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.43 / $314.77 / $711.34	Facility		$86.43	$314.77	$711.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.72 / $163.72 / $196.17	Professional		$163.72	$163.72	$196.17
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $214.61 / $637.12 / $637.12	Facility		$214.61	$637.12	$637.12
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $667.97 / $667.97 / $1,005.98	Professional		$667.97	$667.97	$1,005.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $75.11 / $134.13 / $199.85	Facility		$75.11	$134.13	$199.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $134.13 / $134.13 / $167.66	Professional		$134.13	$134.13	$167.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $120.72 / $167.66 / $301.79	Professional		$120.72	$167.66	$301.79
Providence Facility/Professional Facility Modifier Low / Median / High Price $78.87 / $134.13 / $405.53	Facility		$78.87	$134.13	$405.53
Providence Facility/Professional Professional Modifier Low / Median / High Price $126.85 / $147.54 / $234.73	Professional		$126.85	$147.54	$234.73
United Facility/Professional Professional Modifier Low / Median / High Price $56.33 / $56.33 / $134.13	Professional		$56.33	$56.33	$134.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.13 / $181.08 / $279.68	Professional		$134.13	$181.08	$279.68