Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $67.61 / $223.87	Facility		$64.57	$67.61	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $61.66 / $72.44	Professional		$45.71	$61.66	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Professional		$64.57	$64.57	$64.57
BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $389.05 / $616.60	Facility		$169.82	$389.05	$616.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $26.92 / $26.92	Professional		$9.12	$26.92	$26.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $144.54 / $302.00	Professional		$117.49	$144.54	$302.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Facility		$338.84	$338.84	$338.84
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $537.03 / $537.03	Professional		$354.81	$537.03	$537.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $66.07 / $131.83	Facility		$47.86	$66.07	$131.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $61.66 / $75.86	Professional		$47.86	$61.66	$75.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $50.12	Professional		$30.20	$30.20	$50.12
Providence Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $70.79 / $131.83	Facility		$50.12	$70.79	$131.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $125.89 / $302.00	Professional		$66.07	$125.89	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $72.44 / $109.65	Professional		$54.95	$72.44	$109.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $70.79	Professional		$56.23	$56.23	$70.79