Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,158.30 / $3,074.76 / $8,617.04	Facility		$1,158.30	$3,074.76	$8,617.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $982.80 / $1,158.30 / $1,456.65	Professional		$982.80	$1,158.30	$1,456.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,108.81 / $1,253.22 / $5,302.22	Facility		$1,108.81	$1,253.22	$5,302.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,137.67 / $2,137.67 / $2,561.17	Professional		$2,137.67	$2,137.67	$2,561.17
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,808.00 / $8,336.25 / $8,336.25	Facility		$2,808.00	$8,336.25	$8,336.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $8,739.90 / $8,739.90 / $13,162.50	Professional		$8,739.90	$8,739.90	$13,162.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,053.00 / $1,755.00 / $2,614.94	Facility		$1,053.00	$1,755.00	$2,614.94
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,755.00 / $1,755.00 / $2,193.75	Professional		$1,755.00	$1,755.00	$2,193.75
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,579.50 / $2,193.75 / $3,948.75	Professional		$1,579.50	$2,193.75	$3,948.75
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,053.00 / $1,681.47 / $2,988.84	Facility		$1,053.00	$1,681.47	$2,988.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,658.59 / $1,930.50 / $3,071.25	Professional		$1,658.59	$1,930.50	$3,071.25
United Facility/Professional Facility Modifier Low / Median / High Price $737.10 / $1,755.00 / $2,106.00	Facility		$737.10	$1,755.00	$2,106.00
United Facility/Professional Professional Modifier Low / Median / High Price $737.10 / $737.10 / $1,123.20	Professional		$737.10	$737.10	$1,123.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $423.14 / $521.08 / $1,755.00	Professional		$423.14	$521.08	$1,755.00