Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $660.69 / $676.08	Facility		$223.87	$660.69	$676.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $831.76 / $1,380.38	Professional		$602.56	$831.76	$1,380.38
BCBS Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,698.24 / $2,818.38	Facility		$630.96	$1,698.24	$2,818.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $812.83 / $812.83	Professional		$776.25	$812.83	$812.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,995.26 / $5,128.61	Facility		$870.96	$1,995.26	$5,128.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $933.25 / $1,584.89	Professional		$812.83	$933.25	$1,584.89
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,623.41 / $5,623.41 / $5,623.41	Facility		$5,623.41	$5,623.41	$5,623.41
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,623.41 / $7,943.28 / $7,943.28	Professional		$5,623.41	$7,943.28	$7,943.28
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $1,000.00 / $1,698.24	Facility		$616.60	$1,000.00	$1,698.24
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $741.31 / $1,380.38	Professional		$602.56	$741.31	$1,380.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $776.25 / $891.25	Professional		$776.25	$776.25	$891.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $1,230.27 / $3,311.31	Facility		$660.69	$1,230.27	$3,311.31
Providence Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $912.01 / $1,258.93	Professional		$851.14	$912.01	$1,258.93
United Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $870.96 / $1,148.15	Facility		$467.74	$870.96	$1,148.15
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $891.25 / $1,412.54	Professional		$104.71	$891.25	$1,412.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Professional		$891.25	$891.25	$891.25