Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $14.13 / $19.05	Facility	26	$12.02	$14.13	$19.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $263.03	Professional		$125.89	$162.18	$263.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $144.54 / $190.55	Professional		$18.20	$144.54	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $190.55 / $354.81	Professional		$134.90	$190.55	$354.81
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	26	$128.82	$128.82	$128.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,479.11 / $1,479.11	Professional		$1,174.90	$1,479.11	$1,479.11
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $14.13 / $15.85	Facility	26	$12.02	$14.13	$15.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $245.47 / $407.38	Professional		$134.90	$245.47	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $141.25	Professional		$32.36	$33.11	$141.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $190.55 / $354.81	Professional		$138.04	$190.55	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $190.55 / $295.12	Professional		$131.83	$190.55	$295.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $169.82	Professional		$162.18	$162.18	$169.82