Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.20 / $180.40 / $468.29	Facility		$64.20	$180.40	$468.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.22 / $71.02 / $103.61	Professional		$58.22	$71.02	$103.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.79 / $165.71 / $424.70	Facility		$41.79	$165.71	$424.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.42 / $52.64 / $125.69	Professional		$33.42	$52.64	$125.69
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $138.15 / $394.44 / $426.26	Facility		$138.15	$394.44	$426.26
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $629.27 / $629.27 / $629.27	Professional		$629.27	$629.27	$629.27
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $61.44 / $92.67 / $160.27	Facility		$61.44	$92.67	$160.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $65.72 / $65.72 / $71.68	Professional		$65.72	$65.72	$71.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $97.80 / $97.80 / $189.60	Professional		$97.80	$97.80	$189.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $61.78 / $95.84 / $196.27	Facility		$61.78	$95.84	$196.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.33 / $52.64 / $134.30	Professional		$33.33	$52.64	$134.30
United Facility/Professional Facility Modifier Low / Median / High Price $22.02 / $33.84 / $45.64	Facility		$22.02	$33.84	$45.64
United Facility/Professional Professional Modifier Low / Median / High Price $28.02 / $43.35 / $61.93	Professional		$28.02	$43.35	$61.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.05 / $42.05 / $58.87	Professional		$42.05	$42.05	$58.87