Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $240.00 / $240.00 / $384.00	Facility		$240.00	$240.00	$384.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.00 / $240.00 / $269.76	Professional		$240.00	$240.00	$269.76
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $55.00	Facility		$55.00	$55.00	$55.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $240.00 / $240.00 / $508.80	Facility		$240.00	$240.00	$508.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $240.00 / $240.00 / $681.22	Facility		$240.00	$240.00	$681.22
United Facility/Professional Facility Modifier Low / Median / High Price $385.00 / $2,064.00 / $8,759.00	Facility		$385.00	$2,064.00	$8,759.00
United Facility/Professional Professional Modifier Low / Median / High Price $202.72 / $266.07 / $417.07	Professional		$202.72	$266.07	$417.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $208.20 / $208.20 / $281.07	Professional		$208.20	$208.20	$281.07