Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,659.59 / $5,248.07	Facility		$741.31	$1,659.59	$5,248.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $870.96 / $1,258.93	Professional		$691.83	$870.96	$1,258.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $851.14 / $2,630.27	Facility		$741.31	$851.14	$2,630.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,659.59	Professional		$1,380.38	$1,380.38	$1,659.59
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,370.32 / $5,370.32 / $5,370.32	Facility		$5,370.32	$5,370.32	$5,370.32
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,623.41 / $8,511.38 / $8,511.38	Professional		$5,623.41	$8,511.38	$8,511.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,148.15 / $2,137.96	Facility		$870.96	$1,148.15	$2,137.96
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $933.25 / $1,380.38	Professional		$691.83	$933.25	$1,380.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,230.27 / $2,454.71	Professional		$1,148.15	$1,230.27	$2,454.71
Providence Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,071.52 / $2,041.74	Facility		$691.83	$1,071.52	$2,041.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,202.26 / $2,137.96	Professional		$1,071.52	$1,202.26	$2,137.96
United Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $776.25	Professional		$478.63	$478.63	$776.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,202.26	Professional		$1,148.15	$1,148.15	$1,202.26