Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $224.00 / $224.00 / $759.43	Facility		$224.00	$224.00	$759.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $759.43 / $853.29 / $853.29	Professional		$759.43	$853.29	$853.29
BCBS Facility/Professional Facility Modifier Low / Median / High Price $627.20 / $1,686.54 / $2,820.47	Facility		$627.20	$1,686.54	$2,820.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $693.51 / $780.55 / $815.90	Professional		$693.51	$780.55	$815.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $720.48 / $1,903.79 / $4,802.46	Facility		$720.48	$1,903.79	$4,802.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,063.00 / $1,063.00 / $1,063.00	Professional		$1,063.00	$1,063.00	$1,063.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,214.47 / $5,085.64 / $5,085.64	Facility		$4,214.47	$5,085.64	$5,085.64
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,779.12 / $5,609.51 / $7,911.23	Professional		$4,779.12	$5,609.51	$7,911.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $616.65 / $945.56 / $1,715.98	Facility		$616.65	$945.56	$1,715.98
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $850.90 / $850.90 / $850.90	Professional		$850.90	$850.90	$850.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,203.56 / $1,476.21 / $1,660.91	Professional		$1,203.56	$1,476.21	$1,660.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $626.39 / $1,230.10 / $3,190.87	Facility		$626.39	$1,230.10	$3,190.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $850.90 / $882.19 / $1,257.90	Professional		$850.90	$882.19	$1,257.90
United Facility/Professional Facility Modifier Low / Median / High Price $830.00 / $1,156.94 / $1,156.94	Facility		$830.00	$1,156.94	$1,156.94
United Facility/Professional Professional Modifier Low / Median / High Price $103.65 / $937.69 / $1,368.21	Professional		$103.65	$937.69	$1,368.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $445.85 / $815.08 / $1,226.92	Professional		$445.85	$815.08	$1,226.92