Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $2,511.89 / $7,585.78	Facility		$630.96	$2,511.89	$7,585.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $316.23 / $371.54	Professional		$223.87	$316.23	$371.54
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Facility		$1,995.26	$1,995.26	$1,995.26
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,884.03 / $2,884.03	Professional		$2,398.83	$2,884.03	$2,884.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $1,862.09 / $6,025.60	Facility		$331.13	$1,862.09	$6,025.60
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $316.23 / $1,000.00	Professional		$263.03	$316.23	$1,000.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $363.08 / $478.63	Facility		$263.03	$363.08	$478.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $323.59	Professional		$323.59	$323.59	$323.59
United Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $1,047.13 / $2,691.53	Facility		$154.88	$1,047.13	$2,691.53
United Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $338.84 / $512.86	Professional		$251.19	$338.84	$512.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53