Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $3,715.35 / $12,022.64	Facility		$977.24	$3,715.35	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $3,019.95 / $11,748.98	Professional		$794.33	$3,019.95	$11,748.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $3,162.28 / $8,912.51	Facility		$812.83	$3,162.28	$8,912.51
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $5,248.07 / $14,125.38	Professional		$812.83	$5,248.07	$14,125.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $44.67	Professional		$30.20	$30.20	$44.67
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $5,248.07 / $10,964.78	Facility		$1,698.24	$5,248.07	$10,964.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Professional		$316.23	$316.23	$316.23