Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $803.00 / $2,673.00 / $7,542.00	Facility		$803.00	$2,673.00	$7,542.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,112.42 / $1,268.65 / $1,380.24	Professional		$1,112.42	$1,268.65	$1,380.24
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,055.30 / $6,984.13 / $15,229.91	Facility		$4,055.30	$6,984.13	$15,229.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $637.10 / $637.10 / $637.10	Professional		$637.10	$637.10	$637.10
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,988.41 / $14,302.50 / $14,302.50	Facility		$2,988.41	$14,302.50	$14,302.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $9,522.79 / $9,522.79 / $9,522.79	Professional		$9,522.79	$9,522.79	$9,522.79
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $356.84 / $1,296.63 / $2,669.73	Facility		$356.84	$1,296.63	$2,669.73
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $339.85 / $339.85 / $1,261.70	Professional		$339.85	$339.85	$1,261.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $379.24 / $1,333.19 / $2,674.83	Facility		$379.24	$1,333.19	$2,674.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,261.70 / $1,261.70 / $1,261.70	Professional		$1,261.70	$1,261.70	$1,261.70
United Facility/Professional Facility Modifier Low / Median / High Price $1,154.00 / $3,314.00 / $7,600.00	Facility		$1,154.00	$3,314.00	$7,600.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,162.08 / $1,597.87 / $2,469.44	Professional		$1,162.08	$1,597.87	$2,469.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.55 / $1,255.65 / $1,790.06	Professional		$56.55	$1,255.65	$1,790.06