Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $732.00 / $3,682.00 / $10,893.00	Facility		$732.00	$3,682.00	$10,893.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.70 / $256.66 / $286.86	Professional		$223.70	$256.66	$286.86
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $562.94 / $1,147.49 / $1,251.25	Facility		$562.94	$1,147.49	$1,251.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,793.76 / $1,846.48 / $2,148.30	Professional		$1,793.76	$1,846.48	$2,148.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $246.72 / $288.68 / $728.50	Facility		$246.72	$288.68	$728.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $237.61 / $237.61 / $237.61	Professional		$237.61	$237.61	$237.61
Providence Facility/Professional Facility Modifier Low / Median / High Price $246.72 / $308.89 / $728.50	Facility		$246.72	$308.89	$728.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $237.61 / $237.61 / $237.61	Professional		$237.61	$237.61	$237.61
United Facility/Professional Facility Modifier Low / Median / High Price $385.00 / $2,064.00 / $8,759.00	Facility		$385.00	$2,064.00	$8,759.00
United Facility/Professional Professional Modifier Low / Median / High Price $219.14 / $301.31 / $465.66	Professional		$219.14	$301.31	$465.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $204.74 / $204.74 / $276.39	Professional		$204.74	$204.74	$276.39