Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $3,630.78 / $12,022.64	Facility		$831.76	$3,630.78	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $512.86 / $776.25	Professional		$512.86	$512.86	$776.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $870.96 / $4,265.80	Facility		$512.86	$870.96	$4,265.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Professional		$371.54	$371.54	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $524.81 / $933.25	Professional		$331.13	$524.81	$933.25
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Facility		$1,995.26	$1,995.26	$1,995.26
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $4,466.84 / $4,466.84	Professional		$2,754.23	$4,466.84	$4,466.84
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $1,479.11 / $6,918.31	Facility		$512.86	$1,479.11	$6,918.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $512.86 / $1,000.00	Professional		$512.86	$512.86	$1,000.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $50.12	Professional		$30.20	$30.20	$50.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $5.01 / $1,513.56	Professional		$5.01	$5.01	$1,513.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $562.34 / $1,122.02	Facility		$512.86	$562.34	$1,122.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $346.74 / $645.65	Professional		$79.43	$346.74	$645.65
United Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $6,606.93 / $13,803.84	Facility		$2,187.76	$6,606.93	$13,803.84
United Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $912.01 / $1,318.26	Professional		$436.52	$912.01	$1,318.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Professional		$1,047.13	$1,047.13	$1,047.13