Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $921.00 / $3,620.00 / $12,281.00	Facility		$921.00	$3,620.00	$12,281.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.27 / $391.04 / $437.82	Professional		$255.27	$391.04	$437.82
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,003.40 / $23,689.15 / $23,689.15	Facility		$2,003.40	$23,689.15	$23,689.15
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,083.44 / $3,172.72 / $3,696.90	Professional		$3,083.44	$3,172.72	$3,696.90
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $391.04 / $457.55 / $829.00	Facility		$391.04	$457.55	$829.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $408.46 / $444.56 / $13,222.00	Professional		$408.46	$444.56	$13,222.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $391.04 / $457.55 / $829.00	Facility		$391.04	$457.55	$829.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $408.46 / $408.46 / $408.46	Professional		$408.46	$408.46	$408.46
United Facility/Professional Facility Modifier Low / Median / High Price $4,409.00 / $9,027.00 / $20,955.00	Facility		$4,409.00	$9,027.00	$20,955.00
United Facility/Professional Professional Modifier Low / Median / High Price $263.31 / $362.05 / $547.19	Professional		$263.31	$362.05	$547.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $444.56 / $495.87 / $611.89	Professional		$444.56	$495.87	$611.89