Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $921.00 / $3,682.00 / $12,480.00	Facility		$921.00	$3,682.00	$12,480.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.12 / $224.85 / $245.20	Professional		$147.12	$224.85	$245.20
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,356.12 / $15,056.25 / $15,056.25	Facility		$1,356.12	$15,056.25	$15,056.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,739.12 / $1,788.72 / $2,083.28	Professional		$1,739.12	$1,788.72	$2,083.28
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $193.03 / $243.67 / $348.45	Facility		$193.03	$243.67	$348.45
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $230.41 / $230.41 / $230.41	Professional		$230.41	$230.41	$230.41
Providence Facility/Professional Facility Modifier Low / Median / High Price $193.03 / $243.67 / $348.45	Facility		$193.03	$243.67	$348.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $230.41 / $230.41 / $313.48	Professional		$230.41	$230.41	$313.48
United Facility/Professional Facility Modifier Low / Median / High Price $2,093.00 / $5,931.00 / $13,134.00	Facility		$2,093.00	$5,931.00	$13,134.00
United Facility/Professional Professional Modifier Low / Median / High Price $187.31 / $249.74 / $396.43	Professional		$187.31	$249.74	$396.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $235.16 / $235.16 / $317.47	Professional		$235.16	$235.16	$317.47