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 $161.68 / $252.58 / $273.35	Professional		$161.68	$252.58	$273.35
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,683.43 / $2,059.75 / $2,116.31	Facility		$1,683.43	$2,059.75	$2,116.31
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,408.45 / $1,432.13 / $2,217.08	Professional		$1,408.45	$1,432.13	$2,217.08
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $220.62 / $265.60 / $390.89	Facility		$220.62	$265.60	$390.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $245.13 / $245.13 / $245.13	Professional		$245.13	$245.13	$245.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $220.62 / $265.60 / $390.89	Facility		$220.62	$265.60	$390.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $245.13 / $245.13 / $353.79	Professional		$245.13	$245.13	$353.79
United Facility/Professional Facility Modifier Low / Median / High Price $390.00 / $1,986.00 / $8,759.00	Facility		$390.00	$1,986.00	$8,759.00
United Facility/Professional Professional Modifier Low / Median / High Price $211.40 / $285.98 / $431.97	Professional		$211.40	$285.98	$431.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $235.16 / $254.75 / $360.63	Professional		$235.16	$254.75	$360.63