Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $797.00 / $3,682.00 / $11,453.00	Facility		$797.00	$3,682.00	$11,453.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $412.89 / $594.97 / $833.19	Professional		$412.89	$594.97	$833.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $771.00 / $771.00 / $771.00	Professional		$771.00	$771.00	$771.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,108.64 / $7,298.90 / $14,839.49	Facility		$4,108.64	$7,298.90	$14,839.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,086.96 / $1,278.78 / $1,278.78	Professional		$1,086.96	$1,278.78	$1,278.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $649.17 / $5,315.00 / $9,352.00	Facility		$649.17	$5,315.00	$9,352.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $552.84 / $735.53 / $1,160.03	Professional		$552.84	$735.53	$1,160.03
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $13,486.75	Facility		$55.00	$55.00	$13,486.75
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,882.48 / $4,219.60 / $4,924.28	Professional		$3,882.48	$4,219.60	$4,924.28
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $252.46 / $560.84 / $1,166.42	Facility		$252.46	$560.84	$1,166.42
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $227.64 / $487.44 / $9,074.00	Professional		$227.64	$487.44	$9,074.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.00 / $7.00 / $903.91	Professional		$7.00	$7.00	$903.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $265.98 / $571.54 / $1,306.68	Facility		$265.98	$571.54	$1,306.68
Providence Facility/Professional Professional Modifier Low / Median / High Price $564.70 / $736.79 / $1,183.47	Professional		$564.70	$736.79	$1,183.47
United Facility/Professional Facility Modifier Low / Median / High Price $2,093.00 / $5,870.00 / $13,237.00	Facility		$2,093.00	$5,870.00	$13,237.00
United Facility/Professional Professional Modifier Low / Median / High Price $395.24 / $588.27 / $1,432.22	Professional		$395.24	$588.27	$1,432.22
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $500.92 / $536.22 / $724.25	Professional		$500.92	$536.22	$724.25